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Hormone replacement therapy plus pelvic floor muscle exercise for postmenopausal stress incontinence: a randomized, controlled trial
Ishiko O, Hirai K, Sumi T, Tatsuta I, Ogita S
The Journal of Reproductive Medicine 2001 Mar;46(3):213-220
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of the combination of pelvic floor muscle exercise (PFME) and estriol on postmenopausal stress incontinence (SI). STUDY DESIGN: Sixty-six patients with postmenopausal SI were randomized to a group treated with a combination of estriol (1 mg/d) and PFME (group A, n = 32) and a group treated with PFME alone (group B, n = 34). Efficacy was evaluated every three months based on stress scores obtained from a urinary incontinence (UI) questionnaire. RESULTS: A significant decrease in stress score was observed in mild and moderate UI patients in both groups three months after the commencement of therapy (A and B, p < 0.0001). The therapeutic effect in group A was more prominent for up to 18 months in mild UI and for up to 12 months in moderate UI (A versus B, p < 0.05). Kaplan-Meier analysis showed that the cumulative morbidity rate in mild SI patients was significantly lower in group A (0%) than in group B (12%, p < 0.005). CONCLUSION: Combination therapy with estriol plus PFME was effective and is capable of serving as first-line treatment for mild SI.

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