ABSTRACT
Aim of this study was to evaluate the efficacy of ospemifene in the prevention of recurrent lower urinary tract infections in postmenopausal women with vulvovaginal atrophy. The study have a retrospective design. Thirty-nine patients were enrolled. Patients underwent clinical examination and urine culture. The urinary symptoms and the quality of life were evaluated with UTISA score, PUF and SF-36 questionnaires before and after treatment. All 39 patients received ospemifene 60 mg one tablet/daily for 6 months. Adverse effects and complications were assessed. Thirty-nine patients were enrolled in the study. Two patients experienced one new UTI episode and the mean number of positive urine culture decreased significantly after 6 months (3.65 ± 2.12 vs 0.25 ± 0.17, p < .0001). The mean number of urinary infection symptoms decreased significantly after treatment; dysuria reduced (4.76 ± 2.45 vs 0.89 ± 1.12). PUF score and SF-36 showed a statistically significant change (22.43 ± 5.89 vs 12.14 ± 3.21) and (52.86 ± 9.21 vs 83.43 ± 10.76). No adverse effects were reported and the total success rate was the 92.3% after 6 months at PGI-I. Ospemifene is a valid alternative with excellent tolerability for the UTIS prevention in postmenopausal patients.
Subject(s)
Atrophic Vaginitis/drug therapy , Postmenopause , Selective Estrogen Receptor Modulators/therapeutic use , Tamoxifen/analogs & derivatives , Urinary Tract Infections/prevention & control , Vulvovaginitis/drug therapy , Aged , Atrophic Vaginitis/complications , Atrophic Vaginitis/physiopathology , Atrophic Vaginitis/urine , Dysuria/etiology , Dysuria/prevention & control , Female , Follow-Up Studies , Hospitals, University , Humans , Italy/epidemiology , Lost to Follow-Up , Middle Aged , Quality of Life , Retrospective Studies , Risk Factors , Secondary Prevention , Selective Estrogen Receptor Modulators/adverse effects , Self Report , Severity of Illness Index , Tamoxifen/adverse effects , Tamoxifen/therapeutic use , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiology , Urine/microbiology , Vulvovaginitis/complications , Vulvovaginitis/physiopathology , Vulvovaginitis/urineABSTRACT
Type 1 neurofibromatosis (NF1) is a dominantly inherited neurologic disorder that affects primarily the skin, bones, and peripheral nervous system. It may be associated with a variety of clinical manifestations including cafe-au-lait spots, skinfold freckling, Lisch nodules, and visceral neurofibromas. Individuals affected by NF1 harbor an increased risk for both benign and malignant tumors. Malignant transformation is usually observed in the form of neurosarcoma. Rarely, NF1 affects the genital tract, and isolated vulvar localization is extremely rare. Here is reported a rare case of a solitary neurosarcoma of the vulva in a 43-year-old woman affected by NF1 syndrome treated with surgical excision. The purpose of this case is to underline the possibility of association between NF1 and genital tract sarcoma and to suggest an accurate evaluation of rapid growth vulvar mass in this setting.
