The use of intravaginal oestrogen cream in genuine stress incontinence

Ten women presenting with symptoms of post-menopausal urogenital oestrogen deficiency, including atrophic vaginal changes and a variety of urinary symptoms, were studied urodynamically and shown to have genuine stress incontinence. Their urethral function was assessed by resting and stress pressure profiles before and after treatment with an intravaginal oestrogen cream. A reduction in the severity of symptoms of stress incontinence, urgency and voiding difficulties was found. No significant changes were induced in the resting urethral pressure profile although the maximum urethral closure pressure on stress was significantly increased as a consequence of improved pressure transmission in mid-urethra. The distribution of pressure transmission suggests that the effect of oestrogen therapy may be due to improved efficiency of urethral closure by the pelvic floor in response to stress.