Management and treatment of postmenopausal women with overactive bladder in genitourinary syndrome of menopause
- Authors: Tikhomirova E.V.1, Balan V.E.1, Titchenko J.P.1
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Affiliations:
- Moscow Regional Research Institute of Obstetrics and Gynecology
- Issue: No 12 (2023)
- Pages: 143-151
- Section: Exchange of Experience
- URL: https://journals.eco-vector.com/0300-9092/article/view/625909
- DOI: https://doi.org/10.18565/aig.2023.256
- ID: 625909
Cite item
Abstract
Objective: To optimize the therapy of overactive bladder in peri- and postmenopausal women.
Materials and methods: The study included 70 patients (mean age 57 years) with an average period after menopause of 6.3 years; the patients’ complaints were vaginal dryness, itching, burning, frequent urination during the day and/or at night, and urgent desire to urinate with or without incontinence. The women were divided into two groups: group 1 included 35 women who received estriol 0.5 mg (one dose of Ovestin intravaginally for 21 days daily, then one dose twice a week); group 2 included 35 patients who received a combination of the β3-adrenergic receptor agonist mirabegron (Betmiga 50 mg per day) and estriol 0.5 mg using the same scheme. The effectiveness of therapy was assessed with the help of filled questionnaires and diaries of urination, the findings of the examination and comprehensive urodynamic examination, G. Bachman score for the assessment of urogenital atrophy.
Results: Both groups showed a decrease in the incidence of pollakiuria, nocturia, urgency and urgent urinary incontinence after three months of treatment. The improvements were significantly more remarkable in the combination therapy group. There was a decrease in the severity of symptoms of genitourinary syndrome of menopause, including manifestations of vulvovaginal atrophy, in both groups.
Conclusion: Combination therapy with a β3-adrenergic receptor agonist (mirabegron 50 mg) together with local estrogens (estriol 0.5 mg intravaginally) is more effective against all symptoms of overactive bladder than monotherapy with intravaginal estriol. An important advantage of combination therapy is a two-fold decrease in the frequency of relapses. Local therapy with estriol is effective against the symptoms of vulvovaginal atrophy, both in the form of monotherapy and in combination treatment.
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About the authors
Elena V. Tikhomirova
Moscow Regional Research Institute of Obstetrics and Gynecology
Author for correspondence.
Email: heltik03@gmail.com
ORCID iD: 0000-0002-2977-323X
PhD, Senior Researcher at the Outpatient Department, Moscow Regional Research Institute of Obstetrics and Gynecology
Russian Federation, MoscowVera E. Balan
Moscow Regional Research Institute of Obstetrics and Gynecology
Email: balanmed@gmail.com
ORCID iD: 0000-0002-2364-6838
Dr. Med. Sci., Professor, Head of the Outpatient Department, Moscow Regional Research Institute of Obstetrics and Gynecology
Russian Federation, MoscowJulia P. Titchenko
Moscow Regional Research Institute of Obstetrics and Gynecology
Email: yuliatit@mail.ru
ORCID iD: 0000-0003-4109-0471
PhD, Researcher at the Department of Prenatal Diagnosis, Moscow Regional Research Institute of Obstetrics and Gynecology
Russian Federation, MoscowReferences
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