Effect of short-term of vaginal therapy with prasterone before urogynecological surgery in woman.

Among many different types of vaginal therapy for women suffering from urogynecological disorders, we may distinguish hormonal vaginal treatment with oestrogens. Lately, there has been a new option of treatment- prasterone. It is prohormone which can be further metabolized and acts like both estrogens and androgens. The purpose of the study is to analyze the effect of short-term vaginal application of prasterone. We checked 39 women of age 28-85 suffering from prolapse or stress incontinence that consented to surgical treatment and hadn't used vaginal estrogens before. We analyzed vaginal maturation index (VMI), biocenosis, endometrial thickness, and blood level of estradiol and dehydroepiandrosterone sulfate (DHEA-S) The analyses were performed before and after eight weeks of vaginal preparation with prasterone 6.5 mg once daily, administered intravginally. Results of the main variables before and after treatment were as follows: estradiol [pg/mL] 63.25±101.85 vs. 49.62±99.85 (p=0.94); DHEA-S [µmol/L] 3.93±2.19 vs. 4.28±2.55 (p=0.02); endometrial thickness [mm] 3.65±3.79 vs. 3.97±3.42 (p=0.97); biocenosis score [1-4] 2.95±0.94 vs. 2.50±0.76 (p=0.02). The study showed a significant increase in the DHEA-S levels after treatment and decrease in the degree of biocenosis. No substantial differences were found in relation to estradiol levels, or endometrium size. Moreover, a notable increase in the VMI was observed. Prasterone preparation has the effect of improving vaginal maturation and bacterial flora in both patients with stress urinary incontinence and female organ prolapse. In addition, these parameters are improved in both reproductive and menopausal women.