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Abstract
Among the medical problems associated with aging in women, urogenital aging may well be the most ignored. It can be defined as a process that produces a complex of symptoms and physical findings, involving the lower urinary and genital tracts and the pelvic floor, relating ta a decline in ovarian function and to aging. The prevalence of urogenital aging increases with increasing years; depending on the defining symptoms used, the condition is present in up ta 40 percent of mature women.
The symptoms fall into five groups: urinary, vaginal, bowel, prolapse, and sexual symptoms. Many patients will have symptoms from more than one group. The mainstay of treatment is estrogen, although there are many other important aspects of treatment that merit consideration, ranging from exercises to surgery.
This review will present the epidemiology, assessment, and management of this common condition.
Résumé
Le vieillissement du système génito-urinaire pourrait bien être un des problèmes les plus souvent ignorés chez les femmes d’âge mûr. Ce phénomène, qui s’accompagne d’un ensemble complexe de symptômes et de signes physiques mettant en cause les voies urinaires et génitales inférieures et la structure périnéale, est lié au déclin des fonctions ovariennes et au vieillissement. La prévalence du vieillissement génito-urinaire augmente avec le temps. Selon les symptômes utilisés pour sa définition, la proportion des femmes d’âge mûr qui en sont atteintes pourrait atteindre jusqu’à 40 pour cent.
Les symptômes observés se classent en cinq catégories : troubles urinaires, vaginaux, intestinaux ou sexuels, et prolapsus. Beaucoup de patientes présenteront des symptômes appartenant à plus d’une de ces catégories. Le traitement privilégié utilise les estrogènes, mais beaucoup d’autres aspects importants du traitement, allant de l’exercice physique à la chirurgie, méritent notre attention.
Dans le présent article, nous examinons l’épidémiologie, les méthodes d’évaluation et les méthodes de traitement de ce problème commun.
Key Words
References
- Introduction.in: von Schoultz B Urogenital aging: the proceedings of a symposium held at the VII International Congress on the Menopause, Stockholm, 5weden. Parthenon, New York1994: 1993
- Population projections for Canada, provinces and territories 1993–2016. Statistics Canada, Ottawa1994
- The developing human: clinically oriented embryology. 2nd ed. W.B. Saunders, Philadelphia1977
- Urogenital atrophy.Obstet Gynecol Clin North Am. 1987; 15: 13-32
- Estrogens and the urogenital tract.Acta Obstet Gynecol Scand. 1993; 157: 1-25
Marshburn PB, Carr BR. The menopause and hormone replacement therapy. In: Hazzard WR, Bierman EL, Blass JP, Ettinger WH Jr, Halter JB (Eds). Principles of geriatric medicine and gerontology. 3rd ed. New York: McGrawHill: 867-78.
- Vulvovaginal complaints.in: Lobo RA Treatment of the postmenopausal woman: basic and clinical aspects. 12. Raven Press, New York1994: 137-142
- Menopause and hormone replacement therapy: an overview.Obstet Gynecol. 1996; 87: 25-155
- Collagen: the significance in skin, bones, and bladder.in: Lobo RA Treatment of the postmenopausal woman: basic and clinical aspects. Raven Press, New York1994: 143-151
- Prevalence of genitourinary symptoms in the late menopause.Acta Obstet Gynecol Scand. 1984; 63: 257-260
- The prevalence of urogenital symptoms of estrogen deficiency.in: von Schoultz B Urogenital aging: the proceedings of a symposium held at the VII International Congress on the Menopause, Stockholm, Sweden. 1993. Parthenon, New York1994: 31-50
A Pan-European study on the prevalence of urogenital aging and its perceived impact on “Ouality of life.” Medical Radar International 1995. Project No: 94069.
- Sexuality and menopause.Obstet Gynecol. 1990; 75: 26S-30S
- Geriatric gynecology.in: Hazzard WR Bierman EL Blass JP Ettinger Jr WH Halter JB Principles of geriatric medicine and gerontology. 3rd ed. McGraw-Hill, New York1994: 473-479
- The menopause: psychosexual context.JSOGC. 1994; 16: 1653-1656
- Vaginal dryness in menopausal women: clinical characteristics and non hormonal treatment.Clin Pract Sexuality. 1990; 7: 1-8
- The Canadian guide to clinical preventive health care. Canada Communication Group — Publishing, Ottawa1994
- JSOGC. 1994; 16: 1647-1649
- Reduced mortality associated with long-term postmenopausal estrogen therapy.Obstet Gynecol. 1996; 87: 6-12
- Estrogen as a therapy for stress urinary incontinence: a meta-analysis.JSOGC. 1991; 13: 23-29
- Absorption of estrogens from vaginal cream.N Engl J Med. 1978; 298: 195-197
- Systemic absorption and sustained effects of vaginal estrogen creams.JAMA. 1979; 242: 2699-2700
- Vaginal absorption of estrone and 17-β estradiol.Fertil Steril. 1977; 28: 1063-1066
- Estrogen: urogenital symptoms of deficiency and the rationale for low-dose therapy.in: von Schoultz B Urogenital aging: the proceedings of a symposium held at the VII International Congress on the Menopause, Stockholm, Sweden. 1993. Parthenon, New York1994: 51-58
- Oestradiolreleasing vaginal ring for treatment of postmenopausal urogenital atrophy.Maturitas. 1993; 16: 145-154
Bachmann G. Poster presentation at the North American Menopause Society Meeting, Sept. 20–23,1995. San Francisco.
Article info
Publication history
Accepted:
May 5,
1996
Received in revised form:
May 5,
1996
Received:
April 9,
1996
Identification
Copyright
© 1996 Published by Elsevier Inc.
