Changes in Urethral Cytology following Estrogen Administration

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Abstract
Estrogen vaginal cream was given to 10 postmenopausal women with a diagnosis of genuine stress urinary incontinence. Clinical evaluation and urethral cytology from the midurethra were performed before and after 6 weeks of estrogen treatment. A favorable clinical response was obtained in 50% of the treated patients, in whom signs and symptoms of incontinence disappeared or significantly improved, by subjective and objective evaluation. Cytologic changes at the midurethra correlation well with clinical response to estrogens. Patients with a favorable response to treatment showed a positive ''maturation index'' of squamous epithelium, changing towards more intermediate and superficial cells, and less transitional cells (p < 0.05). Patients with a poor clinical response to estrogens had no significant change in urethral cytology after 6 weeks of therapy. Our results suggest that improvements or cure of stress in continence after estrogen administration in postmenopausal women is achieved by affecting the ''urethral mucosa factor''.