Jármy-Di Bella Z I K, Girão M J B C, Di Bella V, Sartori M G F, Szejnfeld J, Baracat E C, Lima G R
Department of Gynecology at Escola Paulista de Medicina, Federal University of São Paulo, Brazil.
Maturitas. 2007 Mar 20;56(3):297-302. doi: 10.1016/j.maturitas.2006.09.004. Epub 2006 Nov 7.
The lack of estrogen affects the urinary tract mainly by diminishing vascular, muscular and epithelial trophism, resulting in negative effects on continence in postmenopausal women.
Study the effect of hormone therapy (estrogen and progesterone) in periurethral vessels detected by Doppler velocimetric analysis using, as parameters, the number of vessels, resistance and pulsatility indexes, as well as the minimum diastolic value.
Thirty-eight postmenopausal women with stress urinary incontinence were randomized into two groups. The first consisted of women receiving 3 months of estrogen therapy previous to 3 months of continuous estrogen and progesterone combined therapy. The second comprised of women receiving 3 months of continuous estrogen and progesterone therapy. Periurethral Doppler velocimetric analysis was done before hormone administration and during treatment in both groups.
We observed a statistically significant increased number of periurethral vessels during treatment in both groups. There was an increase in value of the mean minimum diastolic value during estrogen and progesterone therapy in Group 2. The resistance indexes diminished in both groups. However, they were not statistically significant.
Hormonal therapy of short duration (3-6 months) had a positive effect on the urethral continence mechanism increasing the number of periurethral vessels either with estrogen alone or combined therapy (estrogen and progesterone).
雌激素缺乏主要通过减少血管、肌肉和上皮的营养作用来影响尿路,从而对绝经后女性的尿失禁产生负面影响。
采用多普勒测速分析检测激素治疗(雌激素和孕激素)对尿道周围血管的影响,以血管数量、阻力和搏动指数以及最小舒张值作为参数。
38例绝经后压力性尿失禁女性被随机分为两组。第一组女性在接受3个月连续雌激素和孕激素联合治疗前先接受3个月雌激素治疗。第二组女性接受3个月连续雌激素和孕激素治疗。两组在激素给药前和治疗期间均进行尿道周围多普勒测速分析。
我们观察到两组治疗期间尿道周围血管数量均有统计学意义的增加。第二组在雌激素和孕激素治疗期间平均最小舒张值增加。两组阻力指数均降低。然而,差异无统计学意义。
短期(3 - 6个月)激素治疗对尿道控尿机制有积极作用,单独使用雌激素或联合治疗(雌激素和孕激素)均可增加尿道周围血管数量。