Estrogen Therapy in the Management of Urinary Incontinence in Postmenopausal Women: A Meta-Analysis. First Report of the Hormones and Urogenital Therapy Committee
Estrogen Therapy in the Management of Urinary Incontinence in Postmenopausal Women: A Meta-Analysis. First Report of the Hormones and Urogenital Therapy Committee
复制标题
雌激素治疗绝经后妇女尿失禁的治疗：荟萃分析。
作者：
J. Fantl;L. Cardozo;D. McClish
目的：对现有数据进行荟萃分析，以评估雌激素治疗治疗绝经后妇女尿失禁的疗效。方法：文献综述纳入了基于 1969 年 1 月至 1992 年 6 月 EXCERPTA MEDICA、BIOSIS 和 MEDLINE 检索的英文文章。标准包括：同行评审的原始文章、尿失禁的确诊诊断、雌激素治疗组以及主观改善的结果数据、液体流失定量或最大尿道闭合压力。此外，数据必须能够在对照试验中比较治疗组和对照组，或者在非对照系列中估计变化。荟萃分析方法仅适用于被视为对照临床试验的研究。结果：审查的166篇文章中，有143篇不符合入选标准； 6 项被视为对照临床试验，17 项被视为非对照系列。荟萃分析发现，雌激素治疗对所有受试者（P<.01）和仅患有真正压力性尿失禁的受试者（P<.05）的主观改善具有总体显着效果。结果显示，对液体流失量没有显着影响，但对最大尿道闭合压力有显着影响（P<.05）。然而，后一个结果仅受到一项显示出巨大影响的研究的影响。结论：从该分析看来，雌激素主观上可以改善绝经后妇女的尿失禁。然而，这些研究包括非同质组，诊断标准、治疗干预和结果评估差异很大。
Objective: To apply a meta-analysis to available data to evaluate the efficacy of estrogen therapy in the management of postmenopausal women with urinary incontinence. Methods: The literature review incorporated English language articles based on a search of EXCERPTA MEDICA, BIOSIS, and MEDLINE from January 1969 to June 1992. Criteria included: peer-reviewed original article, confirmed diagnosis of urinary incontinence, an estrogen-treated group, and outcome data on subjective improvement, quantitation of fluid loss, or maximum urethral closure pressure. In addition, the data had to allow comparison between treated and control groups in controlled trials or an estimated change in uncontrolled series. Meta-analytic methods were applied only to studies considered to be controlled clinical trials. Results: Of 166 articles reviewed, 143 did not meet the entry criteria; six were considered controlled clinical trials and 17 were uncontrolled series. Meta-analysis found an overall significant effect of estrogen therapy on subjective improvement for all subjects (P<.01) and for subjects with genuine stress incontinence alone (P<.05). The results showed no significant effect on quantity of fluid loss but a significant effect (P<.05) on maximum urethral closure pressure. However, the latter result was influenced by only one study showing a large effect. Conclusion: It appears from this analysis that estrogen subjectively improves urinary incontinence in postmenopausal women. However, the studies included nonhomogeneous groups, and the diagnostic criteria, therapeutic interventions, and outcome assessments varied considerably.