title: Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women.
abstract: OBJECTIVE
  To assess the effects of the combination of pelvic floor rehabilitation and intravaginal estriol administration on stress urinary incontinence (SUI), urogenital atrophy and recurrent urinary tract infections in postmenopausal women.
  
  
  METHODS
  Two-hundred-six postmenopausal women with urogenital aging symptoms were enrolled in this prospective randomized controlled study. Patients were randomly divided into two groups and each group consisted of 103 women. Subjects in the treatment group received intravaginal estriol ovules, such as 1 ovule (1 mg) once daily for 2 weeks and then 2 ovules once weekly for a total of 6 months as maintenance therapy plus pelvic floor rehabilitation. Subjects in the control group received only intravaginal estriol in a similar regimen. We evaluated urogenital symptomatology, urine cultures, colposcopic findings, urethral cytologic findings, urethral pressure profiles and urethrocystometry before, as well as after 6 months of treatment.
  
  
  RESULTS
  After therapy, the symptoms and signs of urogenital atrophy significantly improved in both groups. 61/83 (73.49%) of the treated patients, and only 10/103 (9.71%) of the control patients referred a subjective improvement of their incontinence. In the patients treated by combination therapy with estriol plus pelvic floor rehabilitation, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure (MUP), in mean urethral closure pressure (MUCP), as well as in the abdominal pressure transmission ratio to the proximal urethra (PTR).
  
  
  CONCLUSIONS
  Our results showed that combination therapy with estriol plus pelvic floor rehabilitation was effective and should be considered as a first-line treatment for symptoms of urogenital aging in postmenopausal women.
authors.affiliation: Urogynecology Unit, Gynecologic and Obstetric Clinic, University of Sassari, Viale San Pietro 12, 07100 Sassari, Italy. capobsass@tiscali.it
authors.forename: Giampiero
authors.initials: G
authors.lastname: Capobianco
authors.forename: Ermes
authors.initials: E
authors.lastname: Donolo
authors.forename: Gianna
authors.initials: G
authors.lastname: Borghero
authors.forename: Francesco
authors.initials: F
authors.lastname: Dessole
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Cherchi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Dessole
mesh_terms: D000282:Administration, Intravaginal; D000375:Aging; D000704:Analysis of Variance; D001284:Atrophy / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation; D004414:Dyspareunia / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation; D004599:Electric Stimulation Therapy; D004964:Estriol / Q000627:therapeutic use*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D017698:Postmenopause; D011312:Pressure; D014521:Urethra / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation; D014566:Urogenital System / Q000473:pathology* / Q000503:physiopathology*; D014621:Vagina / Q000473:pathology / Q000503:physiopathology
chemical_list: D004964:Estriol