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폐경 후 요로계 변화와 폐경호르몬치료 효과

Changes of Urinary Tract after Menopause and Effectiveness of Menopausal Hormone Replacement Therapy

김태희|김준모
대한폐경학회 (Korean Society Of Menopause)|2011.12|대한폐경학회지 (Journal of Menopausal Medicine)|제17권 제3호|pp. 136-141|DOI http://dx.doi.org/

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참고문헌

키워드

폐경Infection감염Menopause요실금Urinary incontinenceUrinary tractHormone replacement therapy요로감염호르몬 요법

초록

폐경 후 여성호르몬 감소에 따른 요로기능의 변화로 과민성 방광, 복압성 요실금, 재발성 요로감염과 같은 질환의 발생률이 높아지게 된다. 본 연구는 여성호르몬이 하부요로기능에 미치는 영향 및 폐경 후 요로기능의 변화와 함께 여러 형태의 폐경호르몬요법에 따른 과민성 방광, 복압성 요실금, 재발성의 치료 또는 예방효과에 대해서 보고자 한다.

Abstract

Because sex hormones influence the lower urinary tract, menopause can cause several urinary diseases including overactive bladder, stress urinary incontinence and recurrent urinary tract infection. However, the results of many clinical studies have indicated that menopausal hormone replacement therapy is not effective for the treatment of previous diseases, especially via the oral route. Although estrogen vaginal cream or pessary is an effective treatment for overactive bladders and can prevent recurrent urinary tract infection, its beneficial effects only last for the duration of the treatment. If patients with previous mentioned urologic disease have other local symptoms and conditions, such as atrophic vaginitis and dyspareunia, local estrogen replacement therapy will be helpful in relieving the local symptoms. However, the potential for breast cancer or return of withdrawal of bleeding, patient’s age, adverse effect of systemic administration, estrogen-progesterone combination therapy, and effectiveness among other treatment modalities must be considered before a treatment decision can be made. In this article, we will review the current issues on the relationship among urinary tract and sex hormone and menopause, and the effectiveness of menopausal hormone replacement therapy for the treatment of overactive bladders, stress urinary tract incontinence and recurrent urinary tract infection. (J Korean Soc Menopause 2011;17:136-141)

참고문헌 (40)

  1. Robinson D, "Estrogens and the lower urinary tract", Neurourol Urodyn, 30, pp.754~757 (2011)
  2. .Iosif CS, "Estrogen receptors in the human female lower uninary tract", Am J Obstet Gynecol, 141, pp.817~820 (1981)
  3. Batra SC, "Progesterone receptors in the female lower urinary tract", J Urol, 138, pp.1301~1304 (1987)
  4. Van Geelen JM, "Thomas CM, Martin CB Jr. Urodynamic studies in the normal menstrual cycle: the relationship between hormonal changes during the menstrual cycle and the urethral pressure profile", Am J Obstet Gynecol, 141, pp.384~392 (1981)
  5. Hextall A, "The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation", BJOG, 108, pp.1193~1196 (2001)
  6. Rechberger T, "The controversies regarding the role of estrogens in urogynecology", Folia Histochem Cytobiol, 45, pp.s17~21 (2007)
  7. Samsioe G, "Urogenital aging--a hidden problem", Am J Obstet Gynecol, 178, pp.s245~249 (1998)
  8. Hextall A, "The role of estrogen supplementation in lower urinary tract dysfunction", Int Urogynecol J Pelvic Floor Dysfunct, 12, pp.258~261 (2001)
  9. Stamey TA, "Studies of introital colonization in women with recurrent urinary infections. I. The role of vaginal pH", J Urol, 114, pp.261~263 (1975)
  10. Molander U, "Effect of oral oestriol on vaginal flora and cytology and urogenital symptoms in the post-menopause", Maturitas, 12, pp.113~120 (1990)
  11. Milsom I, "Factors influencing vaginal cytology, pH and bacterial flora in elderly women", Acta Obstet Gynecol Scand, 72, pp.286~291 (1993)
  12. Lee YS, "Prevalence of overactive bladder, urinary incontinence, and lower urinary tract symptoms: results of Korean EPIC study", World J Urol, 29, pp.185~190 (2011)
  13. Iosif CS, "Prevalence of genito-urinary symptoms in the late menopause", Acta Obstet Gynecol Scand, 63, pp.257~260 (1984)
  14. Brown JS, "Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors", Obstet Gynecol, 98, pp.1045~1052 (2001)
  15. Foxman B, "Urinary tract infection: self-reported incidence and associated costs", Ann Epidemiol, 10, pp.509~515 (2000)
  16. Harrington RD, "Urinary tract infection risk factors and gender", J Gend Specif Med, 3, pp.27~34 (2000)
  17. Hooton TM, "A prospective study of risk factors for symptomatic urinary tract infection in young women", N Engl J Med, 335, pp.468~474 (1996)
  18. Falconer C, "Decreased collagen synthesis in stress-incontinent women", Obstet Gynecol, 84, pp.583~586 (1994)
  19. Jackson S, "The effect of oestrogen supplementation on post-menopausal urinary stress incontinence: a double-blind placebo-controlled trial", Br J Obstet Gynaecol, 106, pp.711~718 (1999)
  20. Rechberger T, "Role of fascial collagen in stress urinary incontinence", Am J Obstet Gynecol, 179, pp.1511~1514 (1998)
  21. Jackson S, "The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence", BJOG, 109, pp.339~344 (2002)
  22. Fleischmann N, "The effect of ovariectomy and long-term estrogen replacement on bladder structure and function in the rat", J Urol, 168, pp.1265~1268 (2002)
  23. Robinson D, "Effects of estrogen and progestin replacement on the urogenital tract of the ovariectomized cynomolgus monkey", Neurourol Urodyn, 15, pp.215~221 (1996)
  24. Fantl JA, "Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the Hormones and Urogenital Therapy Committee", Obstet Gynecol, 83, pp.12~18 (1994)
  25. Wilson PD, "Treatment with oral piperazine oestrone sulphate for genuine stress incontinence in postmenopausal women", Br J Obstet Gynaecol, 94, pp.568~574 (1987)
  26. Moehrer B, "Oestrogens for urinary incontinence in women", Cochrane Database Syst Rev, 2, pp.CD001405~ (2003)
  27. Sultana CJ, "Estrogen and urinary incontinence in women", Maturitas, 20, pp.129~138 (1994)
  28. Ishiko O, "Hormone replacement therapy plus pelvic floor muscle exercise for postmenopausal stress incontinence. A randomized, controlled trial", J Reprod Med, 46, pp.213~220 (2001)
  29. Cardozo L, "A systematic review of estrogens for recurrent urinary tract infections: third report of the hormones and urogenital therapy (HUT) committee", Int Urogynecol J Pelvic Floor Dysfunct, 12, pp.15~20 (2001)
  30. Bhatia NN, "Effects of estrogen on urethral function in women with urinary incontinence", Am J Obstet Gynecol, 160, pp.176~181 (1989)
  31. Simunic V, "Local estrogen treatment in patients with urogenital symptoms", Int J Gynaecol Obstet, 82, pp.187~197 (2003)
  32. Serati M, "Is there a synergistic effect of topical oestrogens when administered with antimuscarinics in the treatment of symptomatic detrusor overactivity", Eur Urol, 55, pp.713~719 (2009)
  33. Ewies AA, "Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick", Climacteric, 13, pp.405~418 (2010)
  34. Fu X, "Expression of estrogen receptor-alpha and -beta in anterior vaginal walls of genuine stress incontinent women", Int Urogynecol J Pelvic Floor Dysfunct, 14, pp.276~281 (2003)
  35. Cody JD, "Oestrogen therapy for urinary incontinence in post-menopausal women", Cochrane Database Syst Rev, 4, pp.CD001405~ (2009)
  36. Raz R, "A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections", N Engl J Med, 329, pp.753~756 (1993)
  37. Eriksen B, "A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women", Am J Obstet Gynecol, 180, pp.1072~1079 (1999)
  38. Raz R, "Effectiveness of estriol-containing vaginal pessaries and nitrofurantoin macrocrystal therapy in the prevention of recurrent urinary tract infection in postmenopausal women", Clin Infect Dis, 36, pp.1362~1368 (2003)
  39. .Xu R, "Prevention and treatment of recurrent urinary system infection with estrogen cream in postmenopausal women", Zhonghua Fu Chan Ke Za Zhi, 36, pp.531~533 (2001)
  40. Cardozo L, "Low dose oestrogen prophylaxis for recurrent urinary tract infections in elderly women", Br J Obstet Gynaecol, 1998(105), pp.403~407 (1998)

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