title: The Effect of Vaginal Oestriol Cream on Subjective and Objective Symptoms of Stress Urinary Incontinence and Vaginal Atrophy: An International Multi-Centre Pilot Study.
abstract: OBJECTIVE
  Subjectively and objectively assess stress urinary incontinence (SUI) symptoms before and after topical oestrogen therapy.
  
  
  METHODS
  A prospective study was performed in 3 centres in South-Africa, Australia and the Netherlands. Postmenopausal women with SUI were treated with topical oestriol cream for 6 weeks. The primary subjective outcome was the Patient's Global Impression of Improvement (PGI-I) scale. The primary objective outcome was vaginal pH. Secondary subjective outcomes were: the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form, the Incontinence Impact Questionnaire, the Urogenital Distress Inventory (UDI-6) and the most bothersome symptom approach. Secondary objective outcome was the erect cough pad test. Compliance was scored.
  
  
  RESULTS
  A total of 68 women were enrolled. Half of the participants reported improvement on the PGI-I scale after treatment. Vaginal pH was significantly lower after treatment (median 5.3 (interquartile range (IQR) 4.5-6.0) vs. 5.0 (4.4-5.4), p = 0.002). Improvement on the UDI stress domain was observed (p = 0.01). No statistically significant differences were found in the other subjective outcomes. Baseline and repeat cough pad tests demonstrated a wide variation with no significant difference. Compliance was high (median 100 (IQR 83-100%)).
  
  
  CONCLUSIONS
  Topical oestriol cream during 6 weeks improved quality of life and vaginal pH but no other objective measures of incontinence.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Maaike A
authors.initials: MA
authors.lastname: Weber
authors.forename: Veronica
authors.initials: V
authors.lastname: Lim
authors.forename: Josephine
authors.initials: J
authors.lastname: Oryszczyn
authors.forename: Nevine
authors.initials: N
authors.lastname: Te West
authors.forename: Judith
authors.initials: J
authors.lastname: Souget
authors.forename: Stephen
authors.initials: S
authors.lastname: Jeffery
authors.forename: Jan Paul W R
authors.initials: JP
authors.lastname: Roovers
authors.forename: Kate H
authors.initials: KH
authors.lastname: Moore
mesh_terms: D000282:Administration, Intravaginal; D000368:Aged; D001284:Atrophy; D004964:Estriol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008875:Middle Aged; D010865:Pilot Projects; D017698:Postmenopause; D011446:Prospective Studies; D014550:Urinary Incontinence, Stress / Q000188:drug therapy*; D064804:Urological Agents / Q000008:administration & dosage*; D014622:Vaginal Creams, Foams, and Jellies; D014623:Vaginal Diseases / Q000188:drug therapy*
chemical_list: D064804:Urological Agents; D014622:Vaginal Creams, Foams, and Jellies; D004964:Estriol