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Recurrent urinary tract infection in postmenopausal women role of intravaginal estrogen: A meta-analysis .


Jo-Ann Caroll Dacawi,
Maria Sheila Leynes,
Lolita  B. Micu,
Mary-Lynne Due,
Dinna Cruz,
Marie Antoinette Lontok

Related Institution

St. Luke's Medical Center, Quezon City, Metro Manila, Philippines

Publication Information

Publication Type
Sub Type
Journal Article, Original
Philippine Journal of Internal Medicine
Date of Publication
January-February 2006
ISSN 0119-9641


BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections. At least 7 million women seek treatment for recurrent symptoms of UTI per year. 10-15 percent of women 60 years old and older have recurrent UTI. The most important factor appears to be estrogen depletion. Hence, the use of intravaginal estrogen. OBJECTIVES: The objective of this meta-analysis is to determine the efficacy of intravaginal estrogen replacement therapy on preventing recurrent urinary tract infection in postmenopausal women. SEARCH STRATEGY: Selection criteria. The inclusion criteria used in this review are: originally published articles that were randomized controlled trials, peer reviewed and represent a parallel design having postmenopausal women with confirmed history of recurrent UTI as subjects and used intravaginal estrogen as a treatment arm. TYPES OF OUTCOME MEASURES: The outcome of therapy was UTI confirmed by at least two of the following criteria: patient symptoms, physician report and microbiological techniques (cytological report, culture). The relative risk reduction, absolute risk reduction and NNT were determined. DATA COLLECTION AND ANALYSIS: The search was restricted to studies conducted on human subjects and classified as randomized controlled trials in the MED LINE database and Cochrane Renal Group Library. Eleven trials were considered for the meta-analysis. Only five trials met these criteria and were included In the meta-analysis. MAIN RESULTS: There was a total of 402 subjects. Recurrent UTI was noted at 51.5 percent of estrogen treated population, and 70 percent of the control group. There was a 26.4 percent relative risk reduction and 18.5 percent absolute risk reduction. The number needed to treat was computed to be 5 (p-0.014). REVIEWERS' CONCLUSIONS: This meta-analysis, based on the valid studies reviewed, showed significant difference as to using estrogen in decreasing frequency of recurrent UTI in postmenopausal women.


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