Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Obstetrics and Gynaecology
  • Obstetrics and Gynaecology News
  • Perioperative Vaginal...

Perioperative Vaginal Estrogen fails to reduce prolapse recurrence after transvaginal repair: JAMA

Written By : Dr. Kamal Kant Kohli Published On 2023-08-21T04:15:22+05:30  |  Updated On 21 Aug 2023 6:21 AM IST
Perioperative Vaginal Estrogen fails to  reduce prolapse recurrence after transvaginal repair: JAMA
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Researchers have found in a new study that Perioperative application of intravaginal estrogen cream in postmenopausal women undergoing a standardized native tissue apical vaginal prolapse repair may not reduce prolapse recurrence.

The clinical trial published in JAMA by David D. Rahn and colleagues conducted across three tertiary medical centers in the US has examined the effects of perioperative vaginal estrogen on the success of surgical repair for apical and uterovaginal prolapse in postmenopausal women. The study aimed to compare the efficacy of vaginal estrogen with a placebo cream in reducing the recurrence of prolapse following native tissue surgical repair.

The trial enrolled 206 postmenopausal women who were experiencing bothersome anterior and apical vaginal prolapse and were interested in surgical repair. Out of these, 186 women underwent surgery and were randomized to receive either 1g of conjugated estrogen cream (0.625 mg/g) or a placebo. The intervention involved applying the cream vaginally nightly for 2 weeks and then twice weekly for at least 5 weeks before surgery. The application continued twice weekly for 12 months postoperatively. The surgical procedure included vaginal hysterectomy (if uterus present) and standardized apical fixation using uterosacral or sacrospinous ligament fixation.

The primary outcome of the study was the time to failure of prolapse repair within 12 months after surgery. Failure was defined by at least one of three criteria: anatomical/objective prolapse of the anterior or posterior walls beyond the hymen, apex descending more than one-third of the vaginal length, subjective vaginal bulge symptoms, or repeated prolapse treatment.

  • The study found that perioperative vaginal estrogen did not significantly improve surgical success rates.
  • The 12-month failure incidence was 19% for the vaginal estrogen group and 9% for the placebo group.
  • The adjusted hazard ratio was 1.97 (95% CI, 0.92-4.22), indicating no significant difference in outcomes between the two groups.
  • The most common component of failure was anatomic recurrence, rather than vaginal bulge symptoms or repeated prolapse treatment.

The assessment of vaginal tissue quality and estrogenization by masked surgeons at the time of the operation was significantly better in the vaginal estrogen group. In participants with bothersome vaginal atrophy symptoms at baseline, the vaginal atrophy score for the most bothersome symptom was significantly better at 12 months with vaginal estrogen.

In conclusion, the study found that perioperative vaginal estrogen application did not lead to improved surgical success rates after native tissue transvaginal prolapse repair. This research contributes valuable insights into the potential effects of estrogen in surgical prolapse management and highlights the complexities of such interventions in postmenopausal women. Further studies may be needed to explore alternative strategies for enhancing surgical outcomes in prolapse repair.

Reference:

Rahn, D. D., Richter, H. E., Sung, V. W., Pruszynski, J. E., & Hynan, L. S. (2023). Perioperative vaginal estrogen as adjunct to native tissue vaginal apical prolapse repair: A randomized clinical trial. JAMA: The Journal of the American Medical Association, 330(7), 615. https://doi.org/10.1001/jama.2023.12317


JAMAuterovaginal prolapseVaginal EstrogenProlapse Repair
Source : JAMA
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension, Dyslipidemia, and Familial ASCVD Risk

Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension,...

Featured image representing thinking

Is Pharma Marketing Going Through "Thinking Recession"?

Beyond BMI: Why Pioglitazone Deserves a Place in Managing Thin-Fat Type 2 Diabetes in India

Beyond BMI: Why Pioglitazone Deserves a Place in Managing 'Thin-Fat' Type 2 Diabetes in India

How to Improve Adherence in Hypertensive Patients? Bridging the Gap with CONNECT Tool

How to Improve Adherence in Hypertensive Patients? Bridging the Gap with CONNECT Tool

Vestibular Migraine: Clinical Update and Role of Buccal Prochlorperazine

Vestibular Migraine: Clinical Update and Role of Buccal Prochlorperazine

View All

Journal Club Today

Role of Sunscreen in Children Dr. Tarun Anand Explains

Role of Sunscreen in Children Dr. Tarun Anand Explains

View All

Health News Today

Health Bulletin 1/July/ 2025

Health Bulletin 1/July/ 2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok