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Effect of estrogen on vaginal complications of pessary use: a systematic review and meta-analysis.
Climacteric. 2022 Jun 13 [Online ahead of print]C

Abstract

OBJECTIVE

We aimed to systematically review the impact of local estrogen use in combination with a pessary on vaginal complications in postmenopausal women with pelvic organ prolapse (POP).

METHODS

We searched databases including Medline, Embase, PubMed, Clinical Trials and the Cochrane Central Register of Controlled Trials for relevant literature published in English from inception to 31 May 2021. Only randomized controlled trials (RCTs) and cohort studies were included.

RESULTS

In total, five studies were included (three RCTs, one prospective study and one retrospective cohort study). The meta-analysis was performed with subgroups. Our results indicated a significantly lower incidence of bacterial vaginosis (BV) among postmenopausal women who used estrogen than among controls, with a total pooled odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.11-0.72; I2 = 38%; p = 0.008). The summary ORs of the estrogen use group were 0.98 (95% CI: 0.59-1.63; I2 = 41%; p = 0.95) for vaginal ulceration, 0.80 (95% CI: 0.42-1.54; I2 = 29%; p = 0.50) for vaginal bleeding and 0.74 (95% CI: 0.35-1.58; I2 = 35%; p = 0.44) for vaginal discharge.

CONCLUSIONS

Local estrogen in combination with a pessary could decrease the BV rate among postmenopausal women with POP. However, consensus regarding the value of estrogen use for decreasing other pessary complications has not yet been reached. Additional multicenter RCTs with large sample sizes should be conducted to better understand the effect of estrogen use on reducing pessary-related complications.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35695119

Citation

Ai, F, et al. "Effect of Estrogen On Vaginal Complications of Pessary Use: a Systematic Review and Meta-analysis." Climacteric : the Journal of the International Menopause Society, 2022, pp. 1-10.
Ai F, Wang Y, Wang J, et al. Effect of estrogen on vaginal complications of pessary use: a systematic review and meta-analysis. Climacteric. 2022.
Ai, F., Wang, Y., Wang, J., Zhou, L., & Wang, S. (2022). Effect of estrogen on vaginal complications of pessary use: a systematic review and meta-analysis. Climacteric : the Journal of the International Menopause Society, 1-10. https://doi.org/10.1080/13697137.2022.2079973
Ai F, et al. Effect of Estrogen On Vaginal Complications of Pessary Use: a Systematic Review and Meta-analysis. Climacteric. 2022 Jun 13;1-10. PubMed PMID: 35695119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of estrogen on vaginal complications of pessary use: a systematic review and meta-analysis. AU - Ai,F, AU - Wang,Y, AU - Wang,J, AU - Zhou,L, AU - Wang,S, Y1 - 2022/06/13/ PY - 2022/6/14/pubmed PY - 2022/6/14/medline PY - 2022/6/13/entrez KW - Estrogen KW - pelvic organ prolapse KW - pessary KW - postmenopausal SP - 1 EP - 10 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric N2 - OBJECTIVE: We aimed to systematically review the impact of local estrogen use in combination with a pessary on vaginal complications in postmenopausal women with pelvic organ prolapse (POP). METHODS: We searched databases including Medline, Embase, PubMed, Clinical Trials and the Cochrane Central Register of Controlled Trials for relevant literature published in English from inception to 31 May 2021. Only randomized controlled trials (RCTs) and cohort studies were included. RESULTS: In total, five studies were included (three RCTs, one prospective study and one retrospective cohort study). The meta-analysis was performed with subgroups. Our results indicated a significantly lower incidence of bacterial vaginosis (BV) among postmenopausal women who used estrogen than among controls, with a total pooled odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.11-0.72; I2 = 38%; p = 0.008). The summary ORs of the estrogen use group were 0.98 (95% CI: 0.59-1.63; I2 = 41%; p = 0.95) for vaginal ulceration, 0.80 (95% CI: 0.42-1.54; I2 = 29%; p = 0.50) for vaginal bleeding and 0.74 (95% CI: 0.35-1.58; I2 = 35%; p = 0.44) for vaginal discharge. CONCLUSIONS: Local estrogen in combination with a pessary could decrease the BV rate among postmenopausal women with POP. However, consensus regarding the value of estrogen use for decreasing other pessary complications has not yet been reached. Additional multicenter RCTs with large sample sizes should be conducted to better understand the effect of estrogen use on reducing pessary-related complications. SN - 1473-0804 UR - https://www.unboundmedicine.com/medline/citation/35695119/Effect_of_estrogen_on_vaginal_complications_of_pessary_use:_a_systematic_review_and_meta-analysis. DB - PRIME DP - Unbound Medicine ER -
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