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Changes in urethral cytology following estrogen administration
A Bergman1, M M Karram, N N Bhatia
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Gynecologic and Obstetric Investigation
|January 1, 1990
Summary
Topical estrogen cream improved stress urinary incontinence in 50% of postmenopausal women. Urethral cytology changes correlated with symptom improvement, suggesting an effect on the urethral mucosal factor.
Area of Science:
- Gynecology
- Urology
- Gerontology
Background:
- Postmenopausal women frequently experience genuine stress urinary incontinence.
- Estrogen deficiency can impact urethral tissues, potentially contributing to incontinence.
Purpose of the Study:
- To evaluate the efficacy of vaginal estrogen cream in treating genuine stress urinary incontinence in postmenopausal women.
- To assess the correlation between urethral cytology and clinical response to estrogen therapy.
Main Methods:
- Ten postmenopausal women with genuine stress urinary incontinence received vaginal estrogen cream for 6 weeks.
- Clinical evaluations and midurethral cytologic assessments were conducted before and after treatment.
Main Results:
- Fifty percent of patients showed significant improvement or resolution of stress urinary incontinence symptoms.
- Favorable clinical responders exhibited positive changes in urethral cytology, specifically an increased maturation index (p < 0.05).
- Poor responders did not display significant cytologic alterations.
Conclusions:
- Vaginal estrogen therapy can effectively improve genuine stress urinary incontinence in postmenopausal women.
- Changes in urethral cytology correlate with clinical outcomes, indicating estrogen's role in modulating the 'urethral mucosal factor'.