A randomized clinical trial of the impact of local estrogen on postoperative tissue quality after vaginal reconstructive surgery.

Abstract

OBJECTIVE:

To evaluate the use and effect of early administration of vaginal estrogen via a continuous low-dose estradiol vaginal ring placed immediately after pelvic reconstructive surgery.

METHODS:

This was a randomized controlled trial of 65 postmenopausal women undergoing vaginal reconstructive surgery. The subjects were randomly assigned to receive an estradiol-releasing vaginal ring, placebo vaginal ring, or control without vaginal ring for 12 weeks immediately after vaginal reconstructive surgery. The primary outcome was tissue quality based on vaginal maturation 3 months postoperatively. Secondary outcome measures were subjective and objective signs of atrophy; vaginal pH; the presence of granulation tissue, microscopic inflammation, and major healing abnormalities; and the ability to tolerate an intravaginal ring.

RESULTS:

At 12 weeks, the estradiol ring group had a significantly improved maturation value (P<0.01) and objective atrophy assessment (P<0.01) compared with the placebo ring and control arms. Granulation tissue was increased in the placebo ring arm (P<0.01). Subjective atrophy scores did not differ among the groups (P=0.39).

CONCLUSIONS:

Early administration of vaginal estrogen after vaginal surgery via an estradiol-releasing ring is feasible and results in improved markers of tissue quality postoperatively compared to placebo and controls.

• Authors: Deborah R Karp, Marjorie Jean-Michel, Yasmin Johnston, Gabriel Suciu, Vivian C Aguilar, G Willy Davila
• Journal: Female pelvic medicine & reconstructive surgery (Female Pelvic Med Reconstr Surg) 2012 Jul-Aug Vol. 18 Issue 4 Pg. 211-5 ISSN: 2151-8378 [Print] United States
• PMID: 22777369 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Estrogens
• Estradiol

Topics

• Administration, Intravaginal
• Aged
• Atrophy (etiology, pathology, prevention & control)
• Cohort Studies
• Contraceptive Devices, Female
• Estradiol (administration & dosage)
• Estrogens (administration & dosage)
• Feasibility Studies
• Female
• Granulation Tissue (drug effects)
• Humans
• Middle Aged
• Pelvic Organ Prolapse (pathology, surgery)
• Postoperative Care
• Treatment Outcome
• Vagina (drug effects, pathology, surgery)
• Wound Healing (drug effects)