Effects of Estrogen on Urethral Function with Urinary Incontinence in Women

Bhatia, Narender N.; Bergman, Arieh; Karram, Mickey M.

doi:10.1097/00006254-198908000-00024

Cited by 31 publications

(38 citation statements)

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“…Treatment for urinary incontinence depends on the cause and type of the urinary incontinence. However, treatment of the two most common types of urinary incontinence, stress incontinence and urge incontinence, usually involve pelvic muscle exercises, bladder training, and medications [41][42][43]. Adherence to these measures that limit urinary incontinence may indeed be hampered by anxiety.…”

Section: Discussionmentioning

confidence: 99%

Anxiety Disorders and Disability Secondary to Urinary Incontinence among Adults over Age 50

Bogner

Gallo

Swartz

et al. 2002

Int J Psychiatry Med

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Objective: No previous research has investigated whether there is an association between anxiety disorders and urinary incontinence. We hypothesized that anxiety disorders would be associated with increased urinary incontinence related disability. Method:Continuing participants who were aged 50 years and older in a longitudinal study of community-dwelling adults who were initially living in East Baltimore in 1981 (n = 787). Participants were classified as incontinent if any uncontrolled urine loss within the 12 months prior to the interview was reported. Urinary incontinence related functional loss was further assessed based on a series of questions relating directly to participants' inability to engage in certain activities due to their urinary incontinence. Anxiety disorders were assessed with standardized interviews.Results: Persons meeting criteria for an anxiety disorder were no more likely to have urinary incontinence than were persons without anxiety disorders (unadjusted odds ratio (OR) = 1.36, 95 percent confidence interval (CI) [0.96, 1.93]). Among people with urinary incontinence (n = 159), persons meeting criteria for anxiety disorders in 1981 and in 1994 were much more likely to report urinary incontinence related functional impairment in 1994 (adjusted OR = 6.51, 95 percent CI [1.42, 29.86 ]).Conclusions: Individuals with changes in day-to-day routines or activities secondary to urinary incontinence were more likely to meet criteria for an anxiety disorder than were other older adults. Further studies must tease out the temporal relationship and whether early detection of urinary incontinence and associated anxiety improves quality of life and functioning.

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Section: Discussionmentioning

confidence: 99%

Anxiety Disorders and Disability Secondary to Urinary Incontinence among Adults over Age 50

Bogner

Gallo

Swartz

et al. 2002

Int J Psychiatry Med

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“…In the female lower urinary tract estrogen recep tors (ER) have been detected by different ligand-binding assays [1][2][3] suggesting the possibility of hormonal in fluence on the tissue. Progesterone receptors (PR) have not yet been described in the bladder [4][5][6], Flowever, estrogen treatment is successful in only 50% of the cases [7][8][9] and, according to the literature, these results differ [ …”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Evidence of Estrogen and Progesterone Receptors in the Female Lower Urinary Tract and Comparison with the Vagina

Wolf

Wandt

Jonat

1991

Gynecol Obstet Invest

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Tissue biopsies from the lower urinary tract and the vagina were obtained from 51 and 45 women, respectively, during incontinence surgery or other gynecological operation procedures in order to calculate hormone receptor content. We compared the results between premenopausal, postmenopausal patients with and those without hormonal treatment. Utilizing the enzyme immunohistochemical assay we were able to demonstrate nuclear estrogen and progesterone receptors in the smooth muscle of the trigone and the posterior part of the bladder neck. But only in about 50% of the patients receptor proteins were detected in the frozen thin sections of these tissues. Biopsies from the anterior part of the bladder neck and the bladder vault were never receptor positive. In the vagina the rate of receptor-positive tissues was about 80%; in comparison, a smaller number of patients had receptor-positive cells in the bladder. From 29 patients we obtained specimens from the trigone and the vagina as well. The correlation of receptor-positive and -negative tissues of both organs was only 66%. Thus tissue biopsies obtained from the vagina only are not sufficient to discuss the probability of hormonal influence of the lower urinary tract.

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“…The urethra and the vag ina develop from the urogenital sinus [1] and it is known that the vaginal and urethral epithelium is stimulated by estrogen [2], The presence of estrogen receptors (ER) and progesterone receptors (PgR) is generally considered a prerequisite for a tissue to recognize estrogen and progestins and to manifest a response to hormonal therapy [3], Estrogen receptors have been detected in the human female urethra [4,5], providing a rationale for estrogen action on the urethral cells. Estrogen treatment may improve urinary incontinence by stimulating the growth of the urethral epithelium [6]. Estrogen may also im prove urethral spincter function by increasing the vascu larity of the submucosal venous plexuses in the urethra [7,8], Finally the connective tissue within and around the urethra and bladder base is of importance for main tenance of continence.…”

Section: Introductionmentioning

confidence: 99%

“…It has also been shown that trans mission of intra-abdominal pressure to the urethra at stress decreases in postmenopausal women and in women treated with antiestrogen [11]. Moreover estro gen treatment seems to restore the abdominal pressure to the urethra, probably due to extraurethral factors as improved pelvic floor function [6,12,13].…”

Section: Introductionmentioning

confidence: 99%

Steroid Hormone Receptors in Pelvic Muscles and Ligaments in Women

Smith

Heimer

Norgren

et al. 1990

Gynecol Obstet Invest

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Using monoclonal antibody assay techniques estrogen receptors (ER) and progesterone receptors (PgR) were quantitated in female pelvic floor muscles, urogenital ligaments and uterus (myometrium). Receptors were detected in all these structures. In addition qualitative assessment showed distinct nuclear staining in the same structures. ER and PgR were not found in the musculus rectus abdominis with either method. The findings provide a rationale for estrogen treatment in women with urogenital disorders.

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Effects of Estrogen on Urethral Function with Urinary Incontinence in Women

Cited by 31 publications

References 0 publications

Anxiety Disorders and Disability Secondary to Urinary Incontinence among Adults over Age 50

Anxiety Disorders and Disability Secondary to Urinary Incontinence among Adults over Age 50

Immunohistochemical Evidence of Estrogen and Progesterone Receptors in the Female Lower Urinary Tract and Comparison with the Vagina

Steroid Hormone Receptors in Pelvic Muscles and Ligaments in Women

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