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[Effect of estriol treatment per vaginam before Burch culposuspension]
S Palomba1, V Napolitano, A Sammartino
1Istituto di Ginecologia, Ostetricia e Fisiopatologia della Riproduzione Umana, Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Naples, Italy.
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.