Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence

Castellani, Daniele; Saldutto, Pietro; Galica, Vikiela; Pace, Gianna; Biferi, Daniela; Galatioto, Giuseppe Paradiso; Vicentini, Carlo

doi:10.1159/000381989

Cited by 13 publications

(14 citation statements)

References 35 publications

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“…Previous researchers pointed out that the prevalence of UI increased with aging [15] . This increase may be explained with the changes in physical status by aging and age-associated factors including, menopause, comorbidities, increased drug use, and parity [1] .…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Possible Risk Factors for Urinary Incontinence: A Cohort Study in the City of Izmir

Demir

Şen²,

İrer³

et al. 2017

Urol Int

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Introduction: This study aimed to evaluate the prevalence and possible risk factors of urinary incontinence (UI) among women aged 18 or older living in the city of Izmir, located in the Aegean coast of Turkey. Methods: A questionnaire and the validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were filled by urologists (O.D., V.S., A.E., O.B., and B.I.) with face-to-face interview. The participants with urge UI (UUI) and stress UI (SUI) were compared in terms of risk factors, quality of life (QoL) scores, severity of incontinence, status of doctor consultation, and total ICIQ-SF scores. Results: A total of 719 women were included and the prevalence of UI was 50.3% in our study. The key risk factors for UUI were hypertension and diabetes mellitus; the key risk factors for SUI were hypertension, multiparity, body mass index, and lower education level. Average QoL (ICIQ-SF 5) score for UUI was worse than SUI (3.8 ± 2.5 vs. 3.3 ± 2.4; p = 0.042) and seeking treatment for UI was significantly higher in participants with UUI when compared to those with SUI (45.1 vs. 24%; p ≤ 0.001). Conclusions: Physicians should be aware that risk factors may differ according to specific UI subtypes when evaluating patients with UI.

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Section: Discussionmentioning

confidence: 99%

“…Parity is the one of the most important risk factors of UI and several previous studies reported that increasing parity was associated with increased risk of UI [13,15,25] . The effect of parity on UI may be related to the development of pelvic muscle atrophy and the impairment in the pelvic muscle nerves during birth [13,25] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Possible Risk Factors for Urinary Incontinence: A Cohort Study in the City of Izmir

Demir

Şen²,

İrer³

et al. 2017

Urol Int

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“…Hot flash was a risk factors for SI. Generally, the lack of estrogen is a risk factor for SI, and estrogen-therapy is an accepted treatment [24]. Therefore, it is acceptable to consider hot flash as a main sign of lack of estrogen and among predictors of SI.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Urinary/Anal Incontinence and Pelvic Organ Prolapse in Healthy Middle-Aged Iranian Women

et al. 2020

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Objectives: Urinary incontinence (UI) and anal incontinence (AI) cause concern, social exclusion, and ultimately reduced quality of life in women. The aim of present study was to assess the prevalence and related risk factors of UI, AI, and pelvic organ prolapse (POP). Methods: The present study recruited 340 menopausal women living in Tabriz in northwest Iran. The data collection tools included the Pelvic Floor Distress Inventory-20 and a personal and social information questionnaire. POP was diagnosed via clinical examination using the simplified pelvic organ prolapse quantification system. Results: The prevalence of UI and POP was approximately 50%, and approximately 16% of participants reported AI. Based on the odds ratios, the most remarkable risk factor of urinary stress incontinence was the number of vaginal deliveries, whereas that of urinary urge incontinence was obesity. Episiotomy and age were the most major risk factors of AI and POP, respectively. Conclusions: The results of the present study showed that the prevalence of POP, UI, and AI is remarkably high among postmenopausal women, warranting the need to prioritize the assessment of POP and various incontinences in middle-aged women in the primary health care system. Furthermore, increased emphasis should be put on modifiable risk factors.

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“…The outcomes of the RCT that evaluated the efficacy of electrical stimulation in the management of stress UI are conflicting [24,28,30]. Consequently, there is a need to conduct more RCT with adequate sample sizes and the use of sensitive, reproducible, and valid outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…A RCT by Castellani et al compared the relative effectiveness of the combination of PHT (PCET, electrical stimulation, and EMG biofeedback) with medication (intravaginal estriol) to treat the stress UI of postmenopausal women [28]. Sixty-two women diagnosed with the disorder were allocated randomly into two groups.…”

Section: Urinary and Fecal (Anal) Incontinencementioning

confidence: 99%

Efficacy of Physical Therapy in the Management of Reproductive Disorders

Balogun¹

2020

Physical Therapy Effectiveness

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Several textbooks and anecdotal reports exist on the management of reproductive disorders by physical therapy (PHT). However, the recommendations from these sources are often not supported by recent empirical outcome evidence. Thus, there is a need for a comprehensive, up-to-date appraisal of the effectiveness of PHT in the management of reproductive disorders. An exhaustive review of the relevant articles published between 1988 and 2019 was undertaken on the primary electronic databases. The search produced 352 "hits," but only 47 of them met the stated purpose of the review and subsequently classified into nine disease domains. The overwhelming majority (91%) of the 47 articles reviewed found the PHT modalities being investigated to be effective. The credibility of the work ranges from "poor" (for the case reports) to "strong" (for the meta-analysis). The pubococcygeus contraction exercise training (PCET), aka Kegel's exercise, was the most studied modality, followed by aerobic exercise. Although substantial evidence suggests that PCET and transvaginal electrical stimulation are effective for reducing the symptoms of stress urinary incontinence (UI), the data on adjunctive techniques (EMG biofeedback, and vaginal cones) are less consistent. There is presently no reliable evidence to support the use of PCET in combination with EMG biofeedback and electrical stimulation to relieve overactive bladder and improve sexual function in men. The conflicting findings are because many of the published studies are heterogeneous in methodology with variant time frame follow-up; therefore, making firm conclusion difficult. There is a need for more randomized controlled trials (RCT) with adequate sample sizes and the use of sensitive, reproducible, and valid outcome measures. In conclusion, systematic reviews and meta-analyses are needed to bolster the rationale for recommending PHT in the management of chronic pelvic diseases in women. Similarly, RCT is required to support the recommendation for using PCET, electric stimulation, and EMG biofeedback to treat ejaculatory/orgasmic dysfunction, prostatitis, UI and erectile dysfunction in men. The information in this chapter will be useful to physical therapist students, frontline clinicians, and healthcare policymakers.

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Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence

Cited by 13 publications

References 35 publications

Prevalence and Possible Risk Factors for Urinary Incontinence: A Cohort Study in the City of Izmir

Prevalence and Possible Risk Factors for Urinary Incontinence: A Cohort Study in the City of Izmir

Prevalence and Risk Factors of Urinary/Anal Incontinence and Pelvic Organ Prolapse in Healthy Middle-Aged Iranian Women

Efficacy of Physical Therapy in the Management of Reproductive Disorders

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