Efficacy of estrogen supplementation in the treatment of urinary incontinence
| Autor: | Deirdre Robinson, Jean F. Wyman, J A Fantl, D K McClish, R C Bump |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Gynecology
medicine.medical_specialty business.industry Medroxyprogesterone medicine.medical_treatment Urinary system media_common.quotation_subject Urology Obstetrics and Gynecology Urinary incontinence Hormone replacement therapy (menopause) Placebo medicine.disease Urination law.invention Menopause Randomized controlled trial law medicine medicine.symptom business medicine.drug media_common |
| Zdroj: | Obstetrics & Gynecology. 88:745-749 |
| ISSN: | 0029-7844 |
| Popis: | Objective To assess the efficacy of cyclic postmenopausal hormone replacement in treating urinary incontinence in hypoestrogenic women. Methods Eighty-three hypoestrogenic women complaining of urinary incontinence were included. All patients were community-dwelling, age 45 years or older, with involuntary loss of urine occurring at least once a week and urodynamic evidence of genuine stress incontinence and/or detrusor instability. Evaluation consisted of a comprehensive clinical and urodynamic research protocol. The hypoestrogenic entry criterion was a plasma estradiol level of 30 pg/mL or less. Parabasal cells on vaginal smears were also monitored. The primary outcome was the number of incontinent episodes per week, as documented on a standardized urinary diary. Secondary outcomes were the quantity of fluid loss, voluntary diurnal and nocturnal micturition frequency, generic and condition-specific health-related quality of life measurements, and patient satisfaction. A randomized, placebocontrolled, double-blind design was used. Subjects in the treatment group were given conjugated equine estrogens (0.625 mg) and medroxyprogesterone (10 mg) cyclically for 3 months. Controls received placebo tablets. Results (All results are presented as mean ± standard deviation.) Subjects were 67 ± 9 years old. The menopause duration was 18 ± 11 years. The duration of incontinence was 9 ± 9 years. Estradiol level at baseline was 9 ± 9 pg/mL, and the parabasal cell count was 42 ± 44%. The number of incontinent episodes at baseline was 13 ± 10 for the treatment group and 16 ± 4 for controls. No significant changes occurred in the number of incontinent episodes after treatment: 10 ± 10 for the treatment group, and 13 ± 14 for the controls (P = .7). Also, fluid loss was not changed: 176 ± 106 g for the treatment group and 64 ± 88 g for the control group at baseline, and 101 ± 150 and 51 ± 69 g after treatment, respectively (P = .7). There were no significant differences for either diurnal or nocturnal voluntary micturition, quality of life meassures,or patient's perception of improvement. Conclusion Three-month cyclic hormone replacement therapy did not affect either clinical or quality of life variables of incontinent, hypoestrogenic women. Long-term effects are unlikely to be substantially different. The use of estrogen supplementation as preventive or adjuvant therapy was not evaluated in this study. |
| Databáze: | OpenAIRE |
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