Pauwaert Kim, Goessaert An-Sofie, Ghijselings Lynn, Bower Wendy, Mariman An, Vogelaers Dirk, Depypere Herman, Everaert Karel
Department of Urology, Ghent University Hospital, Belgium.
Faculty of Medicine and Health Science, Department of Human Structure and Repair, Ghent University, Belgium.
Menopause. 2021 Mar 15;28(5):502-510. doi: 10.1097/GME.0000000000001741.
To observe the impact of different hormonal treatment options on nocturia, its causative factors and bother in postmenopausal women.
This prospective study recruited 245 postmenopausal women and divided them into four treatment groups based on patient's choice: Estrogen + Progesterone (E+P), Estrogen-only in patients with a prior hysterectomy, tissue-selective estrogen complex (TSEC) and no treatment. Nocturia and its causative factors were observed using two standardized questionnaires before and after treatment: the International Consultation on Incontinence Questionnaire Nocturia Module and the Targeting the individual's Aetiology of Nocturia to Guide Outcomes (TANGO). The results of the Targeting the individual's Aetiology of Nocturia to Guide Outcomes were divided in four influencing topics of which the sum score was calculated.
A significant reduction in prevalence of nocturia ≥ twice per night was seen after treatment, as the prevalence decreased from 27.7% (59/213) to 16.4% (35/213). Specified per therapy, a significant reduction in nocturnal voiding frequency was observed in patients treated with E+P and TSEC (P = 0.018 and P = 0.018, respectively). This improvement could be explained by a significant reduction in SLEEP sum score in patients treated with E+P and TSEC (P < 0.001, P = 0.013, respectively). Estrogen-only led to a significant change in URINARY TRACT sum score, which is the result of a reduction in urgency prevalence (P = 0.039).
E+P and TSEC treatment led to a significant reduction in nocturia prevalence and bother in women with ≥ 2 nocturnal voids. This effect is mainly the result of improvement in sleep disorders, however an improvement in bladder disorders can be suggested as well. More research is necessary to confirm these findings.
观察不同激素治疗方案对绝经后女性夜尿症、其病因及困扰的影响。
这项前瞻性研究招募了245名绝经后女性，并根据患者选择将她们分为四个治疗组：雌激素+孕激素（E+P）、子宫切除术后仅用雌激素、组织选择性雌激素复合物（TSEC）和不治疗。在治疗前后使用两份标准化问卷观察夜尿症及其病因：国际尿失禁咨询委员会夜尿症模块问卷和针对个体夜尿病因以指导结果（TANGO）问卷。将针对个体夜尿病因以指导结果问卷的结果分为四个影响主题，并计算总分。
治疗后，每晚夜尿≥两次的患病率显著降低，患病率从27.7%（59/213）降至16.4%（35/213）。按具体治疗方法，接受E+P和TSEC治疗的患者夜间排尿频率显著降低（分别为P = 0.018和P = 0.018）。这种改善可以用接受E+P和TSEC治疗的患者睡眠总分显著降低来解释（分别为P < 0.001，P = 0.013）。仅用雌激素导致尿路总分有显著变化，这是尿急患病率降低的结果（P = 0.039）。
E+P和TSEC治疗使夜间排尿≥2次的女性夜尿症患病率和困扰显著降低。这种效果主要是睡眠障碍改善的结果，不过也提示膀胱疾病有所改善。需要更多研究来证实这些发现。
