Histologic and cytologic effects of vaginal estrogen in women with pelvic organ prolapse: a randomized controlled trial

• Published in: Female pelvic medicine & reconstructive surgery Vol. 19; no. 1; p. 34
• Main Authors: Vaccaro, Christine M, Mutema, George K, Fellner, Angela N, Crisp, Catrina C, Estanol, Maria V, Kleeman, Steven D, Pauls, Rachel N
• Format: Journal Article
• Language: English
• Published: United States 01.01.2013
• Subjects: Aged; Estrogens - administration & dosage; Estrogens, Conjugated (USP) - administration & dosage; Female; Humans; Middle Aged; Pelvic Organ Prolapse - complications; Pelvic Organ Prolapse - drug therapy; Pelvic Organ Prolapse - surgery; Preoperative Care; Single-Blind Method; Vagina - drug effects; Vagina - pathology; Vaginal Creams, Foams, and Jellies; Vaginitis - complications; Vaginitis - drug therapy
• ISSN: 2151-8378
• DOI: 10.1097/SPV.0b013e318278cc40

This study aimed to evaluate the histologic and cytologic effects of preoperative vaginal estrogen in women with atrophic vaginitis and pelvic organ prolapse. Forty-two women with atrophic vaginitis and stage greater than or equal to 2 prolapse were enrolled in this assessor-blinded randomized controlled trial comparing daily vaginal estrogen cream use for 2 to 12 weeks preoperatively versus no intervention. Data were analyzed using t test and analysis of variance. Of these 42 women, 22 received treatment and 20 were controls. After a mean 7 (3) weeks of use, the vaginal maturity index increased 15.5% in the treatment group and declined 1.5% in the control group (P < 0.001). The vaginal epithelial thickness was 339 (96) μm in the treatment group compared to 302 (119) μm (P = 0.275) in the controls. Preoperative vaginal estrogen application for 2 to 12 weeks restores vaginal cytology to premenopausal levels, but does not increase vaginal epithelial thickness in women with prolapse.