title: Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence.
abstract: BACKGROUND
  Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women.
  
  
  METHODS
  Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form.
  
  
  RESULTS
  Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1.
  
  
  CONCLUSIONS
  IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI.
authors.affiliation: University of L'Aquila, Urology Unit, Teramo Hospital, Teramo, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Castellani
authors.forename: Pietro
authors.initials: P
authors.lastname: Saldutto
authors.forename: Vikiela
authors.initials: V
authors.lastname: Galica
authors.forename: Gianna
authors.initials: G
authors.lastname: Pace
authors.forename: Daniela
authors.initials: D
authors.lastname: Biferi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paradiso Galatioto
authors.forename: Carlo
authors.initials: C
authors.lastname: Vicentini
mesh_terms: D000282:Administration, Intravaginal; D001676:Biofeedback, Psychology / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004599:Electric Stimulation Therapy / Q000379:methods*; D004964:Estriol / Q000008:administration & dosage*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D017773:Pelvic Floor / Q000503:physiopathology*; D017698:Postmenopause; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation; D014554:Urination / Q000502:physiology
chemical_list: D004964:Estriol