Clinical evaluation and urodynamic study observation in post-menopausal female: a comparative study

Abstract

Background:Menopause is an irreversible and age related phenomenon and serves as an objective sign of reproductive senescence. Atrophic changes within the urogenital tract may occur due to estrogen deficiency and is associated with genitourinary symptoms.

Methods: A total of 66 women who attained natural and surgical menopause with more than twelve months with urogenital symptoms were selected for study.

Results:Age of patients selected for study was between 35-70 years. Majority of the patients 52/66 (78.7%) were presented after minimum 5 yrs of menopause. Among genital symptoms vaginal discharge was significantly higher (p<0.05) in surgical group 46.87% (15/32) in comparison to 26.4% (9/34) natural menopause group. Other symptoms were more frequent in surgical menopause (p>0.05). Among urinary symptoms frequency was the most common symptom in both the groups, 15 (44.12%) in natural menopause and 22 (68.75%) in surgical menopause, more prevalent in surgical group. Urgency was seen in 38.23% in natural menopause and 56.25% in surgical menopause. Incontinence was present in 47.05% in natural menopause and 62.51% in surgical menopause. Among incontinence stress incontinence was most common in the groups, 20.59% in natural group and 37.5 % in surgical group, statistically significant in surgical group. Mixed incontinence was observed in 5.58% in natural menopause; statistically significant in surgical group. Prevalence of urge incontinence was observed more in natural menopause 20.59% and 3.12 % in surgical menopause. There was no statistically significant difference in uroflowmetry parameters between both the groups. In cystometry parameters, volume at first bladder sensation was significantly less in patients with urgency and urge incontinence in both groups. Maximum bladder capacity was less in detrusor overactivity in both the groups. Compliance was poor in patient with urge incontinence in both the groups.

Conclusions:Hypoestrogenism could be an etiological factor in urogenital dysfunction in postmenopausal women with spontaneous menopause and surgical menopause.