Department of Endocrinology, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Strasse 40, Göttingen, Germany.
Exp Gerontol. 2010 Feb;45(2):129-37. doi: 10.1016/j.exger.2009.11.003. Epub 2009 Nov 10.
Whether urinary incontinence in the postmenopause can be prevented or delayed by estrogens is currently controversially debated. Ovariectomized (ovx) rats have been successfully used as models in the past years but plant derived substances with estrogenic effects in the lower urinary tract have not been studied so far. Therefore we compared the effects of a 3 months lasting oral administration of estradiol 17beta (E2) with those of the phytoestrogens equol, genistein and puerarin. They were ovariectomized, fed with test substance containing food and then anaesthetized and catheterized with a biluminal catheter having one outlet in the bladder and another in the urethra at the level of the urethral sphincter. Urethral and bladder pressure were recorded during a 240s period of retrograde bladder filling (2 x 0.5 ml within 30s with 1 min filling intermission). Bladder and urethra pressures were highest in the E2>puerarin>equol>genistein treated animals. Phytoestrogen and E2 treatment resulted in consistently higher urethral than the bladder pressures during the filling period and in the filled status whereas bladder often exceeded urethral pressures in ovx controls. In summary, we demonstrate significant improvement of urethral closure mechanism under E2 and phytoestrogen administration that can be assumed to be beneficial for prevention or therapy of postmenopausal urge incontinence.
绝经后尿失禁是否可以通过雌激素预防或延迟，目前存在争议。过去几年，去卵巢（ovx）大鼠已成功用作模型，但迄今为止尚未研究具有下尿路雌激素作用的植物源性物质。因此，我们比较了 3 个月口服雌二醇 17β（E2）与植物雌激素雌马酚、染料木黄酮和葛根素的作用。它们被去卵巢，用含有测试物质的食物喂养，然后用双腔导管麻醉和导尿，该导管在尿道括约肌水平在膀胱中有一个出口，在尿道中有另一个出口。在逆行膀胱充盈的 240 秒期间（30 秒内两次 0.5 毫升，填充间隔 1 分钟）记录尿道和膀胱压力。在 E2>葛根素>雌马酚>染料木黄酮处理的动物中，尿道和膀胱压力最高。植物雌激素和 E2 治疗导致充盈期和充盈状态下尿道压力始终高于膀胱压力，而在 ovx 对照组中，膀胱压力往往高于尿道压力。总之，我们证明了在 E2 和植物雌激素给药下尿道闭合机制的显著改善，可以假定对预防或治疗绝经后急迫性尿失禁有益。
