Borghero, Gianna (2011) Ruolo della terapia estrogenica locale e della riabilitazione del pavimento pelvico nel trattamento dei disturbi urogenitali in menopausa. Doctoral Thesis.
Aim: the administration of local estrogen therapy can be useful to improve urogenital atrophyc symptomatology in post menopausal women. The objective of our study was evaluate the effectiveness and safety of local estrogen therapy associated with pelvic floor rehabilitation for the treatment of urinary incontinence, urogenital atrophy, and recurrent urinary tract infections. Methods: we performed a retrospective study on 206 post menopausal women suffering from urogenital symptomatology divided in two groups. One group (treatment) was treated with ovules of estriol and rehabilitation of the pelvic floor, the other group (control) was treated only with the estriol. For the perineal rehabilitation we used physical pelviperineal therapy (PPT) and functional electrical stimulation (FES). The parameters considered in evaluating therapeutic effects were: urogenital symptomatology, urine coltures, colposcopic findings, urethral cytologic findings, urethral pressure profiles and urethrocystometry before, as well as after 6 months of treatment. Results: After therapy, the symptoms and signs of urogenital atrophy significantly improved in the treatment group in comparison to the control group. In the treatment group, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure (MUP), in mean urethral closure pressure (MUCP), as well as in the abdominal pressure transmission ratio to the proximal urethra (PTR). Conclusions: Our results showed that intravaginal administration of estriol and pelvic floor rehabilitation could represent a satisfactory therapeutic choice for postmenopausal women with urogenital tract disturbances.
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