1158 Should Urodynamic Study Be Carried Out in All Women With Clinically-Defined Pure Stress Urinary Incontinence Prior to Surgical Intervention?

Abstract

delay bladder sensations of urgency and prevent bladder contractions. Nevertheless, the role of estrogen replacement in the management of urinary incontinence remains controversial.The purpose of this study was to determine the effectiveness of a consistently applied dose of topical estrogen cream in post-menopausal women with Lower urinary tract symptoms including urinary incontinence.METHODS: Forty post-menopausal women with a chief complaint of urinary incontinence were included in our study. They were asked to fill out a series of four separate validated questionnaires (ICIQ-SF, I-QOL, UDI-6, and IIQ-7) regarding their urinary symptoms both before the use of topical estrogen and then again after a three month treatment period. The results were then compared.RESULTS: A total of 40 patients completed the study. The average age of our cohort was 62 (46 -84). Prior to topical estrogen use 27/40 (67.5%) patients experienced symptoms of atrophic vaginitis, 14/40 (35%) patients had had symptoms of urinary tract infections, and 35/40 (87.5%) patients suffered from stress urinary incontinence. After treatment with topical estrogen, only 13/40 (32.5%) patients had symptoms of atrophic vaginitis (pϽ.0005), 4/40 (10%) had symptoms of a UTI (pϽ.002), and just 12/40 (30%) patients complained of stress related urinary incontinence (pϽ.0001).All measured variables in each of the four different validated questionnaires demonstrated statistical significance with a reduction in events after treatment with topical estrogen, including the Incontinence Quality of Life Measure. This tool asks the patient to rate their current feelings regarding their urinary condition on a scale from 0 (terrible) to 10 (pleased). A mean response of 2.45 was recorded before treatment compared to a mean response of 8.0 after treatment (p Ͻ .00008) CONCLUSIONS: Post-menopausal women who suffer from lower urinary tract symptoms including urinary incontinence, can gain a dramatic improvement in their overall quality of life as well as a reduction in symptoms from vaginal atrophy and urinary symptoms including incontinence when using a consistently applied dose of topical estrogen cream.