Effects of estrogen on urethral function in women with urinary incontinence.
In a prospective study, 2 gm of conjugated estrogen vaginal cream was administered daily for a total of 6 weeks in a group of 11 postmenopausal women with urodynamically proved genuine stress incontinence. Midurethral cytologic studies and a complete clinical and urodynamic evaluation were performed twice at 6-week intervals. Clinically, six of the 11 patients (54.5%) were cured or improved significantly after estrogen treatment, whereas the other five patients (45.5%) were clinically unchanged. The favorable clinical response correlated with urodynamic findings of increased urethral closure pressure and improved abdominal pressure transmission to the proximal urethra (p less than 0.05); in the patients who had a poor clinical response to estrogens, no significant changes in urethral dynamics were noted. Changes in urethral cytologic findings also correlated well with clinical and urodynamic findings. Patients with a favorable response to estrogen showed a maturation change from transitional to intermediate squamous epithelium (p less than 0.02), whereas nonresponders showed no significant changes in urethral cells.
Bhatia
N N
NN
Division of Gynecologic Urology, Harbor-University of California Los Angeles Medical Center.
Bergman
A
A
Karram
M M
MM
D000282:Administration, Intravaginal; D004967:Estrogens / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D014521:Urethra / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000503:physiopathology; D014622:Vaginal Creams, Foams, and Jellies
D004967:Estrogens; D014622:Vaginal Creams, Foams, and Jellies