UROGENITAL DISORDERS IN CLIMACTERIC WOMEN: OPTIMIZATION OF TREATMENT MODALITIES


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Abstract

Objective. To evaluate the efficiency of combined (tolterodine + estriol) versus monotherapy with cholinolytics (tolterodine) in peri- and postmenopausal women with overactive bladder (OAB). Subjects and methods. The randomized longitudinal trial included 60 peri- and postmenopausal patients with OAB. They were aged 45 to 70 years (mean age 57.5±12.5 years). A1l the women were divided into 2 groups: 1) 30 patients with OAB were treated with tolterodine 2 mg twice daily; 2) 30 women received combined therapy with tolterodine 2 mg twice daily and estriol cream intravaginally in a 1/2 dose (0.5 mg estriol) twice weekly. The course of treatment lasted 3 months; Group 2 patients continued to use estriol in the above dosage during a year. The diagnosis of OAB was verified in all the patients by comprehensive urodynamic study. Results. In Groups 1 and 2, the treatment efficiency was 69.6 and 87.2%, respectively. Combined therapy doubles remission length after m-cholinolytic withdrawal (mean remission was 5 months in Group 1 and 9 months in Group 2; p<0.001). Conclusion. Despite the fact that m-cholinolytics are justifiably a first-line therapy for imperative urination disorders (Grade A), the performed study has indicated that local hormone replacement therapies in peri- and postmenopausal women with OAB significantly enhance treatment efficiency (75.6 in Group 1 and 87.2% in Group 2, N=60).

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About the authors

E. I ERMAKOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: ermakova.health@mail.ru

V. E BALAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_balan@oparina4.ru

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