title: Combined Vaginal Pelvic Floor Electrical Stimulation (PFS) and Local Vaginal Estrogen for Treatment of Overactive Bladder (OAB) in Perimenopausal Females. Randomized Controlled Trial (RCT).
abstract: OBJECTIVE
  To evaluate the efficacy of combined vaginal pelvic floor electrical stimulation (PFS) and local vaginal estrogen in treatment of female overactive bladder (OAB).
  
  
  METHODS
  This is a randomized controlled trial carried out on 315 perimenopausal females with OAB who were randomly allocated into 3 equal groups. Group A underwent PFS using vaginal probes twice weekly for 12 sessions. Group B received local vaginal estrogen, whereas group C received both PFS and local estrogen. All patients were evaluated by a voiding diary, quality-of-life questionnaire, vaginal examination, urine analysis, blood sugar, ultrasonography, and urodynamic study before and after therapy. Patients were followed up 1 week, 3, and 6 months post-therapy. The analyzed variables included day and night time frequency, incontinence episodes, urgency, quality of life, detrusor overactivity), and functional bladder capacity). Outcome measure was urge incontinence.
  
  
  RESULTS
  Within each group, there was a statistically significant improvement in all variables after treatment. Improvement of urgency was better in group C than in groups A and B (P = .000, .009). Improvement of incontinence was better in groups A and C than in group B (P = .005, .004). Follow-up showed worsening of symptoms within 6 months in all groups except incontinence in group C.
  
  
  CONCLUSIONS
  Vaginal PFS and estrogen found to be effective in treating OAB symptoms in perimenopausal females. Estrogen seems to augment the effect of PFS especially in the treatment of urgency incontinence and can delay its recurrence.
authors.affiliation: Department of Urology, Beni-Suef University, Beni-Suef, Egypt. Electronic address: ahmedabdelbary2010@hotmail.com.
authors.forename: Ahmed Mahmoud
authors.initials: AM
authors.lastname: Abdelbary
authors.affiliation: Department of Urology, Beni-Suef University, Beni-Suef, Egypt.
authors.forename: A Aref
authors.initials: AA
authors.lastname: El-Dessoukey
authors.affiliation: Department of Urology, Beni-Suef University, Beni-Suef, Egypt.
authors.forename: Amr M
authors.initials: AM
authors.lastname: Massoud
authors.affiliation: Department of Urology, Beni-Suef University, Beni-Suef, Egypt.
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Moussa
authors.affiliation: Department of Urology, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Zayed
authors.affiliation: Department of Urology, Cairo University, Cairo, Egypt.
authors.forename: Mohame G
authors.initials: MG
authors.lastname: Elsheikh
authors.affiliation: Department of Urology, Cairo University, Cairo, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Ghoneima
authors.affiliation: Department of Obstetric and Gynecology, Cairo University, Giza, Egypt.
authors.forename: Rana
authors.initials: R
authors.lastname: Abdella
authors.affiliation: Department of Obstetric and Gynecology, Cairo University, Giza, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Yousef
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D004967:Estrogens / Q000627:therapeutic use*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D047648:Perimenopause; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*
chemical_list: D004967:Estrogens; D004966:Estrogens, Conjugated (USP)