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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。

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