Triple therapy with Lactobacilli acidophili, estriol plus pelvic floor rehabilitation for symptoms of urogenital aging in postmenopausal women.
OBJECTIVE
To assess the effects of the combination of pelvic floor rehabilitation, intravaginal estriol and Lactobacillus acidophli administration on stress urinary incontinence (SUI), urogenital atrophy and recurrent urinary tract infections in postmenopausal women.


METHODS
136 postmenopausal women with urogenital aging symptoms were enrolled in this prospective randomized study.


METHODS
randomly divided into two groups and each group consisted of 68 women.


METHODS
Subjects in the triple therapy (group I) received 1 intravaginal ovule containing 30 mcg estriol and Lactobacilli acidophili (50 mg lyophilisate containing at least 100 million live bacteria) such as once daily for 2 weeks and then two ovules once weekly for a total of 6 months as maintenance therapy plus pelvic floor rehabilitation. Subjects in the group II received one intravaginal estriol ovule (1 mg) plus pelvic floor rehabilitation in a similar regimen.


METHODS
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. 45/59 (76.27%) of the group I and 26/63 (41.27%) of the group II referred a subjective improvement of their incontinence. In the patients treated by triple therapy with lactobacilli, estriol plus pelvic floor rehabilitation, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure, in mean urethral closure pressure, as well as in the abdominal pressure transmission ratio to the proximal urethra.


CONCLUSIONS
Our results showed that triple therapy with L. acidophili, estriol plus pelvic floor rehabilitation was effective and should be considered as first-line treatment for symptoms of urogenital aging in postmenopausal women.
Department of Surgical, Microsurgical and Medical Sciences Gynecologic and Obstetric Clinic, University of Sassari, 07100 Viale San Pietro 12, Sassari, Italy, capobsass@tiscali.it.
Giampiero
G
Capobianco
Jean Marie
JM
Wenger
Giovanni Battista
GB
Meloni
Margherita
M
Dessole
Pier Luigi
PL
Cherchi
Salvatore
S
Dessole
D000282:Administration, Intravaginal; D000368:Aged; D000375:Aging / Q000502:physiology*; D001284:Atrophy / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D004599:Electric Stimulation Therapy; D004964:Estriol / Q000008:administration & dosage / Q000627:therapeutic use*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007778:Lactobacillus; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D017698:Postmenopause; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*; D014552:Urinary Tract Infections / Q000503:physiopathology / Q000628:therapy*; D014566:Urogenital System / Q000473:pathology* / Q000503:physiopathology*
D004964:Estriol