Journal
FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY
Volume 19, Issue 1, Pages 34-39Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SPV.0b013e318278cc40
Keywords
atrophic vaginitis; pelvic organ prolapse; vaginal estrogen; vaginal histology; vaginal maturity index
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Funding
- Hatton Institute for Research and Education, Good Samaritan Hospital, Cincinnati, OH
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Objective: This study aimed to evaluate the histologic and cytologic effects of preoperative vaginal estrogen in women with atrophic vaginitis and pelvic organ prolapse. Methods: 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. Results: 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) mu m in the treatment group compared to 302 (119) mu m (P = 0.275) in the controls. Conclusions: 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.
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