BJOG. 2021 Aug 31. doi: 10.1111/1471-0528.16894. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate if locally applied vaginal estrogen affects prolapse-associated complaints compared to placebo treatment in postmenopausal women prior to surgical prolapse repair.
DESIGN: Randomised, double-masked, placebo-controlled, multicenter study.
SETTING: Urogynaecology unit at the Medical University of Vienna and University Hospital of Tulln.
POPULATION: Postmenopausal women with symptomatic pelvic organ prolapse and planned surgical prolapse repair.
METHODS: Women were randomly assigned local estrogen cream or placebo cream 6 weeks preoperatively.
MAIN OUTCOME MEASURES: Primary outcome was differences in subjective prolapse-associated complaints after 6 weeks of treatment prior to surgery assessed with the comprehensive German pelvic floor questionnaire. Secondary outcomes included differences in other pelvic floor associated complaints (bladder, bowel, sexual function).
RESULTS: Out of 120 randomised women 103 (86%) remained for final analysis. After 6 weeks of treatment prolapse domain score did not differ between the estrogen and the placebo group (4.4 ± 0.19 vs. 4.6 ± 0.19; mean difference: – 0.21; 95%CI: -0.74 to 0.33; P=.445). Multivariate analysis, including only women with intervention, showed that none of the confounding factors modified response to estradiol.
CONCLUSIONS: These results demonstrate that preoperative locally applied estrogen does not ameliorate prolapse-associated symptoms in postmenopausal women with symptomatic pelvic organ prolapse.
PMID:34464489 | DOI:10.1111/1471-0528.16894
