绝经后妇女尿道症状的vulvovaginal雌激素疗法:一个审查和元分析
Irene Porcari1, Stefano Uccella1, Chiara Casprini1
1Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy.
概括
局部雌激素治疗显著改善更年期妇女下尿路症状 (LUTS),包括尿路感染和尿失禁. 这些证据支持其用于管理这些常见的更年期健康问题.
科学领域:
- 妇科 妇科 妇科 妇科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 更年期管理管理
背景情况:
- 更年期性尿生殖综合征 (GSM) 显著影响女性的生活质量.
- 下尿道症状 (LUTS) 是GSM的一个常见表现.
- Vulvovaginal局部雌激素治疗是一种潜在的治疗GSM相关的LUTS.
研究的目的:
- 在更年期妇女中系统地审查和元分析 vulvovaginal 局部雌激素治疗 LUTS 的疗效.
- 总结有关这种治疗对各种LUTS的影响的现有证据.
- 评估局部雌激素在管理GSM的整体有效性.
主要方法:
- 多个数据库的系统文献搜索 (开始至2024年10月).
- 包括包括治疗前和治疗后数据的研究,用于接受vulvovaginal雌激素治疗的更年期妇女.
- 聚合结果的随机效应元分析.
主要成果:
- 分析了17项涉及2111名患者的研究.
- 在复发性尿路感染 (OR 0.14),压力性尿失禁 (OR 0.12),冲动性尿失禁 (OR 0.22),紧急性 (OR 0.11),频率 (OR 0.22) 和夜尿 (OR 0.24) 中观察到显著改善.
- 阴道pH值显著下降 (平均差异为-1.29).
结论:
- Vulvovaginal局部雌激素治疗在改善更年期妇女的一系列LUTS方面表现出显著的有效性.
- 这些发现支持当前的临床指南,建议这种疗法用于与GSM相关的LUTS.
- 局部雌激素是一种有效的治疗选择,用于管理更年期下尿道症状.
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