[Effect of estriol treatment per vaginam before Burch culposuspension]

Abstract

Background: To assess the effect of estriol treatment per vaginam before Burch culposuspension in postmenopausal women with stress urinary incontinence (IUS).

Design: prospective randomised study.

Setting: Department of Gynaecology, Obstetrics and Physiopathology of Human Reproduction-Medical School-University of Naples Federico II .

Patients: twenty women in postmenopause at least from five years with a urogenital symptomatology due to IUS.

Interventions: women were randomised into one of two groups (treated or control) and they were submitted to an evaluation of vulva and vagina trophism. All the women were submitted to a urodynamic examination and to a transvaginal ultrasonography with evaluation of pubis-bladder neck distance, bladder and proximal urethra position, before treatment, one week before the operation and after six months from the same operation.

Evaluations: subjective symptomatology and urodynamic parameters between treated and control groups before and after operation.

Results: After 12 weeks of treatment, a significant improvement of subjective symptomatology and a not significant improvement of all the urodynamic parameters in the treated group in comparison with the control group have been demonstrated, while any anatomic alteration compared with the basal hasn t been observed. After six months from the operation in all the women a significant reduction of subjective quantity of urine lost after a strain has been demonstrated and significant variations of urodynamic parameters without significant differences between treated group and control group were also observed.

Conclusions: The estriol treatment per vaginam is not so effective on the result of Burch culposuspension in postmenopausal women with IUS.