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Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial.
Int Urogynecol J. 2022 Jul; 33(7):1833-1838.IU

Abstract

INTRODUCTION AND HYPOTHESIS

Evidence and recommendations for the use of intravaginal estrogen for prevention of bacterial vaginosis and pessary-related complications are limited and controversial. We hypothesized that adding intravaginal estrogen to pessary use would decrease the incidence of bacterial vaginosis and other pessary-related complications.

METHODS

A single-center, open-label, randomized, parallel study was conducted between April 2018 and August 2020. Participants were randomized to either receive intravaginal estriol 0.03 mg plus Lactobacillus acidophilus 100 million viable cell vaginal tablets or have no treatment. The Amsel criteria, normal flora index, visual analog scale, Thai version of the ICIQ-VS (International Consultation on Incontinence Questionnaire-Vaginal symptoms) questionnaire, vaginal abrasions and vaginal bleeding were evaluated at entry and at 2- and 14-week follow-up.

RESULTS

Seventy-eight women were included and randomized to two groups (39 women per group). At 2-week follow-up, one participant in the intervention group and two participants in the control group were diagnosed with bacterial vaginosis (2.7% vs. 5.7%, p = 0.609). At 14-week follow-up, two participants in the intervention group and two participants in the control group were diagnosed with bacterial vaginosis (5.7% vs. 6.2%, p = 0.926). Normal flora index was significantly different at 2-week follow-up [8 (6.3) vs. 5 (6.0), p = 0.032]. There was no significant difference in the visual analog scale, Thai version of the ICIQ-VS, vaginal abrasions and vaginal bleeding between the 2- and 14-week follow-ups.

CONCLUSIONS

This study shows no benefit of intravaginal estrogen in reducing bacterial vaginosis, vaginal abrasions, vaginal bleeding and pain in postmenopausal women using a vaginal pessary for pelvic organ prolapse treatment.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Suvit.b@chula.ac.th. Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. Suvit.b@chula.ac.th.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

33991221

Citation

Chiengthong, Keerati, et al. "Effect of Vaginal Estrogen in Postmenopausal Women Using Vaginal Pessary for Pelvic Organ Prolapse Treatment: a Randomized Controlled Trial." International Urogynecology Journal, vol. 33, no. 7, 2022, pp. 1833-1838.
Chiengthong K, Ruanphoo P, Chatsuwan T, et al. Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial. Int Urogynecol J. 2022;33(7):1833-1838.
Chiengthong, K., Ruanphoo, P., Chatsuwan, T., & Bunyavejchevin, S. (2022). Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial. International Urogynecology Journal, 33(7), 1833-1838. https://doi.org/10.1007/s00192-021-04821-y
Chiengthong K, et al. Effect of Vaginal Estrogen in Postmenopausal Women Using Vaginal Pessary for Pelvic Organ Prolapse Treatment: a Randomized Controlled Trial. Int Urogynecol J. 2022;33(7):1833-1838. PubMed PMID: 33991221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial. AU - Chiengthong,Keerati, AU - Ruanphoo,Purim, AU - Chatsuwan,Tanittha, AU - Bunyavejchevin,Suvit, Y1 - 2021/05/15/ PY - 2021/02/08/received PY - 2021/04/18/accepted PY - 2021/5/16/pubmed PY - 2021/5/16/medline PY - 2021/5/15/entrez KW - Bacterial vaginosis KW - Complication KW - Lactobacillus acidophilus KW - Pelvic organ prolapse KW - Pessary KW - Vaginal estrogen SP - 1833 EP - 1838 JF - International urogynecology journal JO - Int Urogynecol J VL - 33 IS - 7 N2 - INTRODUCTION AND HYPOTHESIS: Evidence and recommendations for the use of intravaginal estrogen for prevention of bacterial vaginosis and pessary-related complications are limited and controversial. We hypothesized that adding intravaginal estrogen to pessary use would decrease the incidence of bacterial vaginosis and other pessary-related complications. METHODS: A single-center, open-label, randomized, parallel study was conducted between April 2018 and August 2020. Participants were randomized to either receive intravaginal estriol 0.03 mg plus Lactobacillus acidophilus 100 million viable cell vaginal tablets or have no treatment. The Amsel criteria, normal flora index, visual analog scale, Thai version of the ICIQ-VS (International Consultation on Incontinence Questionnaire-Vaginal symptoms) questionnaire, vaginal abrasions and vaginal bleeding were evaluated at entry and at 2- and 14-week follow-up. RESULTS: Seventy-eight women were included and randomized to two groups (39 women per group). At 2-week follow-up, one participant in the intervention group and two participants in the control group were diagnosed with bacterial vaginosis (2.7% vs. 5.7%, p = 0.609). At 14-week follow-up, two participants in the intervention group and two participants in the control group were diagnosed with bacterial vaginosis (5.7% vs. 6.2%, p = 0.926). Normal flora index was significantly different at 2-week follow-up [8 (6.3) vs. 5 (6.0), p = 0.032]. There was no significant difference in the visual analog scale, Thai version of the ICIQ-VS, vaginal abrasions and vaginal bleeding between the 2- and 14-week follow-ups. CONCLUSIONS: This study shows no benefit of intravaginal estrogen in reducing bacterial vaginosis, vaginal abrasions, vaginal bleeding and pain in postmenopausal women using a vaginal pessary for pelvic organ prolapse treatment. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/33991221/Effect_of_vaginal_estrogen_in_postmenopausal_women_using_vaginal_pessary_for_pelvic_organ_prolapse_treatment:_a_randomized_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -