21 KB76 KB20 KB192920262009Lukanovič, Adolfštevilka:1letnik:78str. I-157-I-160ISSN:1318-0347COBISSID:15394137URN:URN:NBN:SI:doc-AUL2QBZDslSlovensko zdravniško društvoZdravniški vestnikinfekcijetherapyurinska inkontinencazdravljenjeHormonsko zdravljenje v uroginekologiji| Hormonal treatment in urogynecology|Hormonal treatment in urogynecology is based on the knowledge, that urinary and reproductive tracts have common embriologic origin and are also linked anatomically and functionally. Both systems are functioning and changing due to sex steroids influence. Decreased estrogen concentrations are connected to metabolic and trophic changes in all organs with estrogen receptors, i.e. also in urogenital tract. Atrophy of urogenital system in postmenopause is a common causative factor for stress urinary incontinence (SUI) and urge incontinence (UUI). In both estrogen replacement treatment have been introduced, but meta-analyses of the available literature indicate that estrogen therapy is effective only if given vaginaly. Recurrent urinary tract infections (RUTI) occur in postmenopause often as a consequence of structural changes in urinary and reproductive tract to lowered immune protection and colonization with eneterobacteria. In RUTI too, estrogen replacement treatment have been used with the results similar to those with SUI and UUI. Effectiveness of estrogen treatment was evident only in topically applied vaginaly, while oral administration has the same effectiveness as placebo. Structural changes in urogenital tract in postmenopause are the results of estrogen depletion. Estrogen replacement is effective in cases of SUI, UUI and RUTI if it is applied topicaly, the efffect being influenced by the type of estrogen used and duration of treatmentHormonsko zdravljenje v uroginekologiji temelji na védenju, da imajo sečila in genitalije skupno embrionalno osnovo in funkcionalno anatomsko povezavo. Oba sistema delujeta in se spreminjata pod vplivom spolnih hormonov. Pomanjkanje hormonov - zlasti estrogena - povzroči metabolične in trofične spremembe na vseh organih, ki imajo estrogenske receptorje, torej tudi na urogenitalnem traktu. Atrofične spremembe urogenitalnega trakta so najpogostejši vzrok za nastanek stresne urinske inkontinence (SUI) in urgentne inkontinence (UUI). Pri obeh oblikah se je uveljavila uporaba estrogenov, vendar meta-analize raziskav kažejo, da so ugodni učinki tovrstnega zdravljenja prisotni le pri vaginalni uporabi zdravila. Ponavljajoče se okužbe sečil (POUT) v pomenopavzi so pogosto posledica spremenjene strukture urinarnega in reproduktivnega trakta, kar zmanjša imunsko zaščito in omogoča kolonizacijo z enterobakterijami. Tudi pri POUT se je uveljavilo zdravljenje z estrogeni in rezultati so podobni kot pri zdravljenju SUI in UUI. Učinkovita je vaginalna uporaba estrogena, pri peroralni uporabi pa učinek ni boljši kot pri uporabi placeba. Strukturne spremembe na urogenitalnem traktu v pomenopavzi so posledica pomanjkanja estrogena. Dodajanje estrogena pri SUI, UUI in POUT je učinkovito, če se uporablja kot topično zdravilo, vendar je učinek odvisen od vrste estrogena in trajanja zdravljenjaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo