Department of Urogynaecology, St George Hospital, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Neurourol Urodyn. 2023 Apr;42(4):799-806. doi: 10.1002/nau.25165. Epub 2023 Feb 25.
To quantitate the changes in stress urinary incontinence (SUI) outcome measures after 12 weeks of vaginal estriol cream in women with stress incontinence.
A prospective multicentre observational study conducted in tertiary urogynaecology centers. Postmenopausal women with pure SUI or stress predominant mixed urinary incontinence (MUI), not receiving any other treatment for their incontinence were given written instructions regarding digital application of a standard dose of vaginal estriol cream. Outcomes were measured at baseline and 12 weeks. The primary objective outcome was vaginal pH. The primary subjective outcome was the stress domain of the Urogenital Distress Inventory-6 (UDI-6). The secondary objective outcome used was the erect cough stress test. Two quality of life questionnaires and two patient reported outcomes were also included.
The 46 postmenopausal recruits had a median age of 62.1 interquartile range (IQR 56.2-65.4). At follow up, the primary subjective outcome SUI domain [UDI-6] significantly improved from 83.3 (IQR 50-100) to 33.3 (33.3-66.7, p ≤ 0.001) as did vaginal pH [from 5.1 (4.9-5.9) to 4.9 (4.6-5.0] p ≤ 0.001; 18/43 patients (42%) were dry on cough stress test.
Twelve weeks of vaginal estriol cream significantly reduced symptoms of stress urinary incontinence in this sample of postmenopausal women.
定量评估阴道用雌三醇乳膏治疗 12 周后压力性尿失禁（SUI）患者的结局变化。
在三级妇科泌尿科中心进行前瞻性多中心观察性研究。对单纯压力性尿失禁或压力为主的混合性尿失禁（MUI）且未接受任何其他治疗的绝经后女性，给予阴道用雌三醇乳膏标准剂量的书面使用说明。在基线和 12 周时测量结局。主要结局指标为阴道 pH 值。主要结局指标为尿失禁困扰问卷-6 （UDI-6）的压力域。次要结局指标是直立咳嗽应激试验。还包括两个生活质量问卷和两个患者报告的结局。
46 名绝经后招募者的中位年龄为 62.1（四分位距 IQR 56.2-65.4）岁。随访时，SUI 域[UDI-6]显著改善，从 83.3（IQR 50-100）改善至 33.3（33.3-66.7，p≤0.001），阴道 pH 值也从 5.1（4.9-5.9）改善至 4.9（4.6-5.0，p≤0.001）；18/43 名患者（42%）在咳嗽应激试验时为干燥。
阴道用雌三醇乳膏治疗 12 周可显著减轻绝经后女性的压力性尿失禁症状。
