HORMONAL TREATMENT IN UROGYNECOLOGY

  • Adolf Lukanović Ginekološka klinika Univerzitetni klinični center Ljubljana Šlajmerjeva 3 1000 Ljubljana
Keywords: incontinence, stress, urge, recurrent urinary tract infection, estrogen treatment

Abstract

Background. Hormonal treatment in urogynecology is based on the knowledge, that urinary and reproductive tracts have common embriologic origin and are also linked anatomically and functionally. Both systems are functioning and changing due to sex steroids influence. Decreased estrogen concentrations are connected to metabolic and trophic changes in all organs with estrogen receptors, i.e. also in urogenital tract. Atrophy of urogenital system in postmenopause is a common causative factor for stress urinary incontinence (SUI) and urge incontinence (UUI). In both estrogen replacement treatment have been introduced, but meta-analyses of the available literature indicate that estrogen therapy is effective only if given vaginaly. Recurrent urinary tract infections (RUTI) occur in postmenopause often as a consequence of structural changes in urinary and reproductive tract to lowered immune protection and colonization with eneterobacteria. In RUTI too, estrogen replacement treatment have been used with the results similar to those with SUI and UUI. Effectiveness of estrogen treatment was evident only in topically applied vaginaly, while oral administration has the same effectiveness as placebo.

Conclusions. Structural changes in urogenital tract in postmenopause are the results of estrogen depletion. Estrogen replacement is effective in cases of SUI, UUI and RUTI if it is applied topicaly, the efffect being influenced by the type of estrogen used and duration of treatment.

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Published
2018-02-14
How to Cite
1.
Lukanović A. HORMONAL TREATMENT IN UROGYNECOLOGY. ZdravVestn [Internet]. 14Feb.2018 [cited 22Sep.2019];78. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2756
Section
Review