OBJECTIVE: To evaluate whether locally applied vaginal estrogen affects prolapse-associated complaints compared with placebo treatment in postmenopausal women prior to surgical prolapse repair.
DESIGN: Randomised, double-masked, placebo-controlled, multicentre 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: The 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 or sexual function).
RESULTS: Out of 120 women randomised, 103 (86%) remained for the final analysis. After 6 weeks of treatment the prolapse domain score did not differ between the estrogen and the placebo groups (4.4 ± 0.19 versus 4.6 ± 0.19; mean difference, -0.21; 95% CI -0.74 to 0.33; P = 0.445). Multivariate analysis, including only women receiving the intervention, showed that none of the confounding factors modified the 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.
TWEETABLE ABSTRACT: Preoperative local estrogen does not ameliorate prolapse-associated symptoms in postmenopausal women with pelvic organ prolapse.
|Number of pages||9|
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Publication status||Published - Dec 2021|
- Administration, Intravaginal
- Double-Blind Method
- Estrogens/administration & dosage
- Estrogens, Conjugated (USP)/administration & dosage
- Intraoperative Care/methods
- Middle Aged
- Pelvic Floor/physiopathology
- Pelvic Organ Prolapse/drug therapy
- Prospective Studies
- Treatment Outcome