Preoperative treatment with oestradiol in women scheduled for vaginal operation for genital prolapse. A randomised, double-blind trial

Objective - To disclose a clinical and histopathological effect of local low-dose oestradiol treatment on the vagina. Design - A randomised, double-blind trial. Setting - Two gynaecological departments at University Hospitals. Subjects - Forty-eight postmenopausal women scheduled for surgery because of genital prolapse. Intervention - 25μg oestradiol or placebo, administered as vaginal pessaries daily, 3 weeks prior to surgery. Main outcome measures - Cytological, histological and clinical changes of the vaginal mucosa. Results - The thickness of the vaginal wall increased as did the oestrogenic index. No clinical effect was seen apart from decreased incidence of recurrent cystitis postoperatively. Conclusions - Preoperative oestrogen treatment has been shown to reduce the incidence of recurrent cystitis and may be needed for stimulation of vaginal mucosa; the short-term clinical effect is not convincing, however.