The effects of hormone replacement treatment and antimuscarinic drugs on urinary incontinens among postmenopausal women

During the last century life expectancy of the women gets longer in the developed countries. This is resulted in increase of postmenopausal women population. In the menopausal period, because of the estrogen deficiency, low genitourinary system gets atrophy functional disorders like dysurea, nocturea, urgency, urinary incontinence and recurrent urinary tract infection occurs. These symptoms might prevented by hormone replacement therapy. It is supported that urinary incontinance is associated with menopause, however, no direct causative relationship between estrogen deficiency and urinary incontinence determined. In the menopausal period, ovarian failure, psychosomatic disorders and tissue aging are occured and which of these cause urinary incontinence is not known. As urinary incontinence prevalance is increasing after the fifth year of menopause, incontinence may be because of body aging. According to the controlled randomised studies, estrogen alone or with progestrerone does not improve urinary symptoms. The objective of this study is to evaluate the effect of hormone replacement therapy on urinary incontinence in postmenopausal women. It is performed between 1 September 2004 and 31 August 2005 in Cukurova University, Faculty of Medicine, Obstetrics and Gynecology Department, Menopause Unit 124 postmenopausal women who had urinary incontinence were included into the study. The patients were randomised to four groups. In group 1 patients had estrogen alone or hormone replacement therapy. In group2 ptients had trospiyum chlorid, in group three tolderodine and in group 4 only local estrogen. Follow up was done each 3 months for 1 year. During the followups subjective parameters were evaluated. In this prospective cross-sectional cohort study face to face questionnaire was used. According to our study, in the patients who took only hormone replacement therapy only subjective improving were observed. Among all the groups, the patients who took tolderodine symptoms were significiantly improved.