Effect of oestrogen therapy on faecal incontinence in postmenopausal women: a systematic review
| Autor: | Pallavi Latthe, Fiona Bach, B. Zeyah F. Sairally |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Hormone Replacement Therapy Urology medicine.medical_treatment Review Article Placebo law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Prospective cohort study Accidental bowel leakage business.industry Hazard ratio Estrogen Replacement Therapy Obstetrics and Gynecology Faecal incontinence Hormone replacement therapy (menopause) Estrogens Oestrogen therapy Postmenopause Observational Studies as Topic Systematic review 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Observational study Female Postmenopausal business Fecal Incontinence Cohort study |
| Zdroj: | International Urogynecology Journal |
| ISSN: | 1433-3023 |
| Popis: | Introduction and hypothesis Faecal incontinence (FI) is prevalent in postmenopausal women. Oestrogen receptors have been identified in the anal sphincter and have been implicated in the pathogenesis and potential treatment. We sought to evaluate the literature regarding the impact of local and systemic oestrogen therapy on FI in postmenopausal women. Methods A systematic review of all studies in postmenopausal women was performed to establish how oestrogen therapy affects FI. Eight articles were deemed eligible for inclusion following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Their quality was assessed using the Cochrane risk-of-bias tool (RoB-2) and Newcastle–Ottawa quality assessment scale. Results One randomised controlled trial (RCT), two cohort studies, one observational and four cross-sectional studies were identified. The RCT showed an improvement in FI with anal oestrogen (p = 0.002), but this improvement was also observed in the placebo arm (p = 0.013) and no difference was seen between these groups. A prospective observational study demonstrated significant improvement with an oestrogen patch (p = 0.004), but had no control group. Conversely, a large prospective cohort study demonstrated an increased hazard ratio of FI with current (1.32; 95% CI, 1.20–1.45) and previous oestrogen use (1.26; 95% CI, 1.18–1.34) compared with non-users. Conclusion All studies had a high risk of bias and had conflicting views on the effects of oestrogen on FI in postmenopausal women. This review has identified the need for further research in this area by highlighting the paucity of good research for evidence-based practice. We believe that a further RCT of local oestrogen is mandated to draw a valid conclusion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink