Vulvovaginal estrogen therapy for urinary symptoms in postmenopausal women: a review and meta-analysis.

IF 3.2 4区医学 Q1 OBSTETRICS & GYNECOLOGY

Climacteric Pub Date : 2025-06-26 DOI:10.1080/13697137.2025.2517138

Irene Porcari, Stefano Uccella, Chiara Casprini, Mariachiara Bosco, Pier Carlo Zorzato, Simone Garzon

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引用次数: 0

Abstract

Objective: This study aimed to summarize available evidence on the efficacy of vulvovaginal topical estrogen therapy on lower urinary tract symptoms (LUTS) of genitourinary syndrome of menopause.

Method: Multiple databases were systematically searched from inception to October 2024 to identify all studies providing pretreatment and post-treatment data for menopausal women with LUTS who received vulvovaginal estrogen therapy. A random effect meta-analysis was conducted (PROSPERO registration number: CRD42024517516).

Results: Seventeen studies were included for a total of 2111 patients. The pooled odds ratio for the occurrence of considered outcomes after versus before treatment was 0.14 (95% confidence interval [CI] 0.05-0.36; I² = 73%) for recurrent urinary tract infections, 0.12 (95% CI 0.05-0.29; I² = 62%) for stress urinary incontinence, 0.22 (95% CI 0.16-0.32; I² = 0%) for urge incontinence, 0.11 (95% CI 0.06-0.18; I² = 23%) for urgency, 0.22 (95% CI 0.16-0.23; I² = 0%) for frequency and 0.24 (95% CI 0.17-0.34; I² = 0%) for nocturia. The pooled mean difference for vaginal pH was -1.29 (95% CI -1.66 to -0.91; I² = 96%).

Conclusions: Vulvovaginal topical estrogen therapy appears to improve all analyzed LUTS in menopausal women. Available evidence supports current guidelines recommending vulvovaginal topical estrogen therapy for the management of these symptoms in menopausal women.

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外阴阴道雌激素治疗绝经后妇女泌尿系统症状：综述和荟萃分析

目的：总结外阴阴道外用雌激素治疗绝经期泌尿生殖系统综合征下尿路症状的疗效。方法：系统检索从成立到2024年10月的多个数据库，以确定所有提供接受外阴阴道雌激素治疗的绝经期LUTS妇女治疗前和治疗后数据的研究。随机效应荟萃分析（PROSPERO注册号：CRD42024517516）。结果：17项研究共纳入2111例患者。治疗后与治疗前发生考虑结果的合并优势比为0.14(95%可信区间[CI] 0.05-0.36；I2 = 73%), 0.12 (95% CI 0.05-0.29；I2 = 62%)为压力性尿失禁，0.22 (95% CI 0.16-0.32；急迫性尿失禁I2 = 0%), 0.11 (95% CI 0.06-0.18；I2 = 23%), 0.22 (95% CI 0.16-0.23；I2 = 0%), 0.24 (95% CI 0.17-0.34；I2 = 0%)夜尿症。阴道pH值的汇总平均差异为-1.29 (95% CI为-1.66至-0.91；I2 = 96%)。结论：外阴阴道外用雌激素治疗可以改善绝经期妇女的LUTS。现有证据支持目前的指南建议外阴阴道局部雌激素治疗绝经妇女这些症状的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Climacteric 医学-妇产科学

CiteScore

1.70

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.