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[Intravesical administration of estriol in sensory urge incontinence--a prospective study].

Local intravaginal application of oestriol is part of the therapeutical programme of sensory urge-incontinence. The effectiveness of a new method--intravesical administration of 1 mg oestriol versus a placebo--has been proved in a prospective randomised study. 21 patients each were treated over a period of three weeks with oestriol or with the placebo-substance intravesically. The effectiveness of the administered therapy was checked with clinical and urodynamic parameters. The intravesical administration of 1 mg oestriol proved to be efficient and free of side effects in respect of the parameters such as imperative micturition, bladder capacity, of the maximum urethral closure pressure as well as the number of micturitions per diem. The intravesical administration of oestriol may be considered as additional method of therapy for treatment of sensory urge-incontinence.

Administration, Intravesical↗

[The effectiveness of intravaginal estriol tablet administration in women with urge incontinence].

In postmenopausal patients, stress and urge incontinence often occur as a consequence of oestrogen deficiency. We performed a comparative study in a prospectively randomised and placebo controlled group of women with urge incontinence to investigate different dosages of intravaginally applied oestriol. Clinical and urodynamic parameters were also compared. 15 women (Group I) received 1 mg oestriol applied daily intravaginally over 3 weeks; 15 women (Group II) received a daily dosage of 3 mg and 10 women received a placebo. A complete clinical and urodynamic evaluation was carried out twice at a 4-week interval. The women receiving a daily dose of 3 mg oestriol applied intravaginally demonstrated a significant improvement of the parameters strong desire to void, pollakisuria, and nycturia. No improvement was seen in patients with motoric urge incontinence.

Administration, Intravaginal↗

[Magnesium, calcium, hemoglobin, hematocrit, estriol and human placental lactogen with magnesium substitution in pregnancy].

In a randomised double-blind study 568 women were given orally either 15 mmol magnesium-aspartate hydrochloride per day or aspartic acid as placebo. The outcome of pregnancy was significantly improved in the magnesium group (fewer maternal hospitalisations, reduction in preterm delivery and less frequent referral of newborn to the neonatal intensive care unit). In the 437 patients with regular intake of tablets, haematocrit, haemoglobin and calcium show a decrease up to 20 weeks of gestation (wks) and an increase during the last 8 wks, whereas magnesium stays at a low level. Oestriol and HPL are rising steadily during gestation. In all parameters, no differences were found between the magnesium and placebo group, except for a higher level of oestriol at 33 to 36 wks and a lower level above 36 wks in the magnesium group. Because of the numerous benefits throughout the pregnancy magnesium supplementation is recommended for all pregnancies.

Aspartic Acid↗

[Significance of the estriol profile as an endogenous function test of the fetoplacental unit].

Oestriol profile represents a functional parameter of the foetal placental unit. Basing on the fact that maternal cortisol regulates oestriol production via a negative feedback action on foetal hypothalamus, relative low serum oestriol concentrations in the morning are compared with increasing oestriol concentrations in the evening, spaced out at short-time intervals, pointing to a dynamic oestriol production of the foetal placental unit. The mean oestriol concentration in the morning and maximum peak values in the evening were determined as criteria of the oestriol profile. In normal pregnancies (n = 74) the oestriol concentration in the morning increases from an average value of 8.0 ng/ml in the 32nd/33rd week to 11.6 ng/ml in the 40th/41st week of gestation. During the same period the peak values in the evening rise from 8.8 to 15.9 ng/ml. The mean cortisol concentrations in normal pregnancies (n = 49) from 32nd to 41st week are in the range of 333 +/- 88 ng/ml in the morning and 205 +/- 66 ng/ml in the evening. There is no significant difference between individual weeks. The predictive value of the oestriol profile was assessed regarding the foetal outcome of 55 high-risk pregnancies. 32 newborn infants exhibited intrauterine growth retardation with birth weights below the 10th and 5th percentile, respectively. In this group 6 patients exhibited low oestriol values in the morning, whereas 12 demonstrated a pathological profile in the evening. In 11 of 12 high-risk pregnancies exhibiting pathological oestriol profile growth, retardation of the newborn was found to be below the 5th percentile. Cortisol concentrations do not significantly differ between normal and high-risk pregnancies.(ABSTRACT TRUNCATED AT 250 WORDS)

Circadian Rhythm↗

[Therapeutic effect of intravaginal application of estriol tablets in the treatment of pathological cervical factor as a cause of sterility].

81 women were included in a prospective randomised 12-year personal study. The "pathological cervical factor" was confirmed by periovulatory daily examination of the quality of the cervical mucus, using a new modified scheme of cervical score by examining the oestrogenic activity in the vaginal smear and results of sperm-penetration tests after Sims- Huhner , partly also by periovulatory determination of the concentration of luteinising hormone in the serum. The presence of ovulatory cycles could also be determined by regular registration of the cycle length, measurement of the basal body temperature and partly by premenstrual endometrium biopsies; these determinations were of course effected during cycles without therapy. All 81 cases with abnormal preovulatory production of cervical mucus were treated in a total of 234 cycles by intravaginal application of oestriol tablets 1 to maximal 3 mg daily for 1 or more subsequent cycles. On the basis of these criteria, the quality of cervical mucus and postcoital tests improved with a satisfying intravaginal resorption of the oestriol tablets; no side effects were seen. After this therapy, very good results were obtained with intravaginally administered oestriol tablets in 59.3% of the patients with a pregnancy rate of 27.2%; 24.7% of the cases only showed a moderate improvement of the mucus; 16.0% did not respond to oestriol treatment and, therefore, had to be considered as therapeutic failures. The present study again confirms the results of other investigators on the local effectiveness of intravaginal application of oestriol tablets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗