Maturitas
Volume 66, Issue 1 , Pages 101-106, May 2010

The use of oestradiol therapy in postmenopausal women after TVT-O anti-incontinence surgery

  • A. Liapis

      Affiliations

    • Department of Urogynaecology and Pelvic Floor Disorders, 2nd Department of Obstetrics & Gynaecology of the University of Athens, Aretaieion Hospital, N. Paritsi 9A, 15451 Neo Psychiko, Athens, Greece
    • Corresponding Author InformationCorresponding author. Fax: +30 210 6712188.
    • ,
  • P. Bakas

      Affiliations

    • Department of Urogynaecology and Pelvic Floor Disorders, 2nd Department of Obstetrics & Gynaecology of the University of Athens, Aretaieion Hospital, N. Paritsi 9A, 15451 Neo Psychiko, Athens, Greece
    • ,
  • C. Georgantopoulou

      Affiliations

    • Obstetrician & Gynaecologist, Obstetric & Gynaecology Unit and Research Centre of the University of Athens, Evgenideion Hospital, Greece
    • ,
  • G. Creatsas

      Affiliations

    • 2nd Department of Obstetrics & Gynecology of the University of Athens, Aretaieion Hospital, Greece

Received 9 September 2009; received in revised form 21 January 2010; accepted 27 January 2010. published online 10 February 2010.

Abstract 

Objective

To investigate whether patients who were treated with TVT-O procedure for urodynamic stress incontinence had a significant improvement in their urodynamic findings and their post-operative symptoms (frequency, urgency, nocturia) if they were treated post-operatively with vaginal oestradiol for 6 months compared to the non-treated group.

Methods

Prospective randomised study. 190 patients were asked to participate in our study. Finally, a total of 92 patients in group 1 and 91 patients in group 2 completed the study. In group 1, which was the treatment group, patients having the TVT-O procedure for urodynamic stress incontinence were instructed to use post-operatively oestradiol tablets, 25 micrograms (Vagifem, Novo Nordisk) vaginally, once daily, nocte, for 2 weeks and then twice weekly for 6 months. The patients in group 2 (control group) had the TVT-O procedure only. All patients were reviewed in 2 months and again in 6 months time.

Results

There was no statistically significant difference between the two groups concerning pre-operative and post-operative haemoglobin, operative time, hospital stay or return to work. The within group analysis did not show significant differences between pre-operative and post-operative urodynamic data in both groups. Patients treated with vaginal estradiol post-operatively showed a statistically significant reduction in relation to the symptoms of urgency and frequency but not in relation to nocturia and urge incontinence compared to the non-treated group. There is no difference in relation to the efficacy of TVT-O procedure between the groups at 6 months follow-up.

Conclusion

It appears that vaginal oestradiol treatment could be offered to postmenopausal patients after a TVT-O procedure having the symptoms of frequency and urgency provided they are aware of the lack of evidence regarding long term benefit.

Keywords: Stress incontinence, Menopause, Urgency, Frequency, Urinary symptoms, TVT-O, Oestrogens

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PII: S0378-5122(10)00047-2

doi:10.1016/j.maturitas.2010.01.020

Maturitas
Volume 66, Issue 1 , Pages 101-106, May 2010

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