title: Histologic and cytologic effects of vaginal estrogen in women with pelvic organ prolapse:  a randomized controlled trial.
abstract: OBJECTIVE
  This study aimed to evaluate the histologic and cytologic effects of preoperative vaginal estrogen in women with atrophic vaginitis and pelvic organ prolapse.
  
  
  METHODS
  Forty-two women with atrophic vaginitis and stage greater than or equal to 2 prolapse were enrolled in this assessor-blinded randomized controlled trial comparing daily vaginal estrogen cream use for 2 to 12 weeks preoperatively versus no intervention. Data were analyzed using t test and analysis of variance.
  
  
  RESULTS
  Of these 42 women, 22 received treatment and 20 were controls. After a mean 7 (3) weeks of use, the vaginal maturity index increased 15.5% in the treatment group and declined 1.5% in the control group (P < 0.001). The vaginal epithelial thickness was 339 (96) μm in the treatment group compared to 302 (119) μm (P = 0.275) in the controls.
  
  
  CONCLUSIONS
  Preoperative vaginal estrogen application for 2 to 12 weeks restores vaginal cytology to premenopausal levels, but does not increase vaginal epithelial thickness in women with prolapse.
authors: Division of Urogynecology and Pelvic Reconstructive Surgery, Madigan Healthcare System, Tacoma, WA, USA. vaccaro.christine@gmail.com
authors: Christine M
authors: CM
authors: Vaccaro
authors: George K
authors: GK
authors: Mutema
authors: Angela N
authors: AN
authors: Fellner
authors: Catrina C
authors: CC
authors: Crisp
authors: Maria V
authors: MV
authors: Estanol
authors: Steven D
authors: SD
authors: Kleeman
authors: Rachel N
authors: RN
authors: Pauls
mesh_terms: D000368:Aged; D004967:Estrogens / Q000008:administration & dosage*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D011300:Preoperative Care; D016037:Single-Blind Method; D014621:Vagina / Q000187:drug effects / Q000473:pathology; D014622:Vaginal Creams, Foams, and Jellies; D014627:Vaginitis / Q000150:complications / Q000188:drug therapy
chemical_list: D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D014622:Vaginal Creams, Foams, and Jellies