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阴道用雌三醇治疗绝经后尿失禁

[Vaginal estriol administration in treatment of postmenopausal urinary incontinence].

作者信息

Schmidbauer C P

机构信息

Urologische Abteilung, Allgemeine Poliklinik der Stadt Wien.

出版信息

Urologe A. 1992 Nov;31(6):384-9.

PMID:1462489
Abstract

In an open, prospective, multicenter, controlled study, 629 female subjects suffering from stress and urgency urinary incontinence were treated with vaginally administered estriol at a dose of 0.01 g daily for 3 weeks, and 0.01 g bi-weekly for a further 3 weeks. All data of 552 patients were available at follow-up after 6 weeks of treatment. The subjective improvement in symptoms of stress urinary incontinence (SUI) was 82% for grade 1, 77% for grade 2, and 69% for grade 3. Voluntary urinary control and symptoms of urgency were improved in more than 80% of patients. Frequency was reduced in almost 50%. Compared with conditions at the outset of the study, after 6 weeks, vaginal lubrication is normal in 77%, and intercourse is no longer painful for 88%. Objective parameters were: no change in existing descent of the anterior vaginal wall, and normal cytoscopic findings in 66% of the patients in whom these were previously pathologic. Vaginal atrophy improved in approximately 40% of cases. A quality of life score revealed improvement in 72%, no change in 20% and worsening in 9% of patients compared with conditions at the start of therapy. During therapy, symptoms worsened in 1%; 2% of patients suffered from the adverse effects, with vaginal itching and burning sensations. Our results confirm the value of topical estrogen application as a cornerstone of efficient treatment of stress and/or urge incontinence in the postmenopausal patient.

摘要

在一项开放性、前瞻性、多中心对照研究中,629名患有压力性和急迫性尿失禁的女性受试者接受了阴道给药雌三醇治疗,剂量为每日0.01克,持续3周,随后每两周0.01克,再持续3周。552名患者的所有数据在治疗6周后的随访时均可获得。压力性尿失禁(SUI)症状的主观改善情况为:1级82%,2级77%,3级69%。超过80%的患者的自主排尿控制和急迫性症状得到改善。尿频减少了近50%。与研究开始时的情况相比,6周后,77%的患者阴道润滑正常,88%的患者性交不再疼痛。客观参数为:阴道前壁现有脱垂情况无变化,66%先前病理检查异常的患者膀胱镜检查结果正常。约40%的病例阴道萎缩有所改善。生活质量评分显示,与治疗开始时相比,72%的患者有所改善,20%无变化,9%恶化。治疗期间,1%的患者症状恶化;2%的患者出现不良反应,表现为阴道瘙痒和烧灼感。我们的结果证实了局部应用雌激素作为绝经后患者压力性和/或急迫性尿失禁有效治疗基石的价值。

相似文献

1
[Vaginal estriol administration in treatment of postmenopausal urinary incontinence].阴道用雌三醇治疗绝经后尿失禁
Urologe A. 1992 Nov;31(6):384-9.
2
[The effectiveness of intravaginal estriol tablet administration in women with urge incontinence].[阴道内给予雌三醇片治疗急迫性尿失禁女性的疗效]
Geburtshilfe Frauenheilkd. 1991 Oct;51(10):834-8. doi: 10.1055/s-2008-1026219.
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Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women.低剂量阴道内使用雌三醇对绝经后女性泌尿生殖系统衰老的疗效。
Menopause. 2004 Jan-Feb;11(1):49-56. doi: 10.1097/01.GME.0000077620.13164.62.
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Vaginal estrogen therapy and overactive bladder symptoms in postmenopausal patients after a tension-free vaginal tape procedure: a randomized clinical trial.无张力阴道吊带术后绝经后患者的阴道雌激素治疗与膀胱过度活动症症状:一项随机临床试验
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[Intravesical administration of estriol in sensory urge incontinence--a prospective study].[雌三醇膀胱内给药治疗感觉性尿急失禁的前瞻性研究]
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Gynakol Geburtshilfliche Rundsch. 1992;32(2):88-91. doi: 10.1159/000271852.
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[Transvaginal estrogen therapy in urinary stress incontinence].经阴道雌激素疗法治疗压力性尿失禁
Minerva Ginecol. 1990 Dec;42(12):539-44.
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Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women.阴道用雌三醇和盆底康复对绝经后妇女泌尿生殖系统衰老的影响。
Arch Gynecol Obstet. 2012 Feb;285(2):397-403. doi: 10.1007/s00404-011-1955-1. Epub 2011 Jun 26.

引用本文的文献

1
Oestrogen therapy for urinary incontinence in post-menopausal women.绝经后女性尿失禁的雌激素治疗
Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD001405. doi: 10.1002/14651858.CD001405.pub3.
2
Local estriol treatment.局部雌三醇治疗。
Dtsch Arztebl Int. 2010 Nov;107(47):841; author reply 842. doi: 10.3238/arztebl.2010.0841a. Epub 2010 Nov 26.
3
[Treatment of female and male stress urinary incontinence. Current aspects].[女性和男性压力性尿失禁的治疗。当前进展]
Urologe A. 2009 Sep;48(9):1059-60, 1062-7. doi: 10.1007/s00120-009-2095-0.