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abstract

133 - THE ROLE OF STEROID HORMONES IN FEMALES WITH STRESS URINARY INCONTINENCE

133

THE ROLE OF STEROID HORMONES INFEMALES WITH STRESS URINARY INCONTINENCE

B. BODNER-ADLER1, K.HALPERN 1, H. HUSSLEIN 1, R. LATERZA 1,E. HANZAL 1, H. KOELBL 1, W. UMEK 2;
1General Gynecology and Gynecologic Oncology, WomensHlth.Inst., Med. Univ. of Vienna, Vienna, Austria, 2GeneralGynecology and Gynecologic Oncology, Womens Hlth.Inst., Med. Univ.Vienna, Vienna, Austria.

Introduction: Urinaryincontinence affects a great portion of postmenopausal women and is amajor cause of quality of life impairment [1]. The levels of sexsteroids, particularly oestrogens and androgens, change markedlyduring menopause and oestrogen deficiency after menopause causesatrophic changes within the urogenital tract and is also associatedwith urinary symptoms [2]. However, it remains unclear whether theincreasing prevalence of urinary tract symptoms is due to thehormonal changes that occur during the menopausal transition, oradvancing age.
Objective: To investigate a potentialrelationship between endogenous sex steroids and the onset anddevelopment of stress urinary incontinence (SUI). Furthermore, weevaluated a potential association between serum steroid hormones andvarious condition-specific pelvic floor domains, using the validatedGerman version of pelvic floor questionnaire.
Methods:Forty-seven peri-and postmenopausal women with SUI were matched 1:1with 47 continent women based on age, menopausal status, BMI andparity. Blood samples were drawn from all patients for assessment ofestradiol (E2), Follicle-stimulating hormone (FSH), Luteinizinghormone (LH), testosterone (T), androstendion (AEON),dehydroepiandrosterone sulphate (DHEAS) and sex hormone bindingglobulin (SHBG) with an electrochemiluminescence immunoassay.Additionally, all patients with SUI received a pelvic floorquestionnaire to determine condition-specific quality of lifedomains. To reach a power of 95%, a overall sample size of 84patients was calculated with an alpha level of 0,05 and an effectsize derived from previously reported serum estradiol levels of 17,30pg/ml (±8,16) for postmenopausal patients with SUI and 24,22 pg/ml(±8,99) for postmenopausal patients without SUI [1]. To account forany dropouts and measurement errors we increased the sample size by10% to a final sample size of 94 patients in all.
Results:Women with stress urinary incontinence had statistically significantlower serum levels of estradiol (8,49 ± 7,47 vs. 13,09 ± 13,80;p=0,048) and androstendion (0,59 ± 0,41 vs. 1,20 ± 0,87; p= 0,033)compared to controls. E2 remained significant after controllingfor age, menopausal age, years from menopause, BMI, parity,testosterone and androstendion. Furthermore, hypertension aswell as history of hysterectomy was found significantly more frequentin the SUI group (p<0,0001). There was no statisticallysignificant association between hormonal levels and mean bladderscore or mean sexual function score (p>0,05).
Conclusions:Our results indicate that a low estradiol level might have a negativeimpact on the function of the lower urogenital system and continencemechanism and work as a possible risk factor for femaleSUI.
References: 1. Augoulea A, Sioutis D, Rizos D,Panoulis C, Triantafyllou N, Armeni E, et al. Stress urinaryincontinence and endogenous sex steroids in postmenopasual women.Neurourol Urodynam 2015 doi: 10.1002/nau.22885. 2. Smith P, Heimer G,Norgren A, Ulmsten U. Localization of steroid hormone receptors inthe pelvic muscles. Eur J Obstet Gynecol Repord Biol. 1993; 50: 83-5.<!--EndFragment-->