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The effects of oestrogen on vaginal wound healing: A systematic review and meta‐analysis
Author(s) -
Vodegel Eva V.,
Kastelein Arnoud W.,
Jansen Charlotte H. J. R.,
Limpens Jacqueline,
Zwolsman Sandra E.,
Roovers JanPaul W. R.,
Hooijmans Carlijn R.,
Guler Zeliha
Publication year - 2022
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24819
Subject(s) - medicine , wound healing , confidence interval , meta analysis , granulation tissue , strictly standardized mean difference , surgery
Aims To determine the effects of oestrogen or oestrogen deprivation on vaginal wound healing. Impaired wound healing following prolapse surgery may increase the risk of recurrent prolapse in the future. Vaginal oestrogen therapy may improve wound healing, hereby possibly improving surgical outcomes. Methods A systematic search of OVID MEDLINE, OVID Embase, and Web of Science was conducted up to January 28, 2020. We included original studies comparing wound healing‐related outcomes of oestrogen exposed subjects (female animals and women) to hypo‐oestrogenic subjects after vaginal surgery. Data on wound healing‐related outcome measures were extracted. For each individual comparison, the standardised mean difference (Hedges' g ; SMD) and 95% confidence interval (CI) were calculated. Results Of the 1474 studies reviewed, 14 studies were included for review, and 11 provided data for meta‐analysis. Oestrogen improves neovascularisation (SMD: 1.13, 95% CI: 0.67–1.60), microscopic wound closure (SMD: 0.98, 95% CI: 0.66–1.29), collagen synthesis (SMD: 1.08, 95% CI: 0.42–1.74), and tissue strength (SMD: 1.26, 95% CI: 0.53–1.99) in animals. Oestrogen increases granulation (SMD: 1.67, 95% CI: 0.54–2.79) and accelerates macroscopic wound closure (SMD: 1.82, 95% CI: 1.22–2.42) in women and animals. Oestrogen decreases the inflammatory response (SMD: −0.58, 95% CI: −1.14 to −0.02) in women and animals and reduces levels of transforming growth factor (TGF)‐β1 (SMD: −1.68, 95% CI: −2.52 to −0.83) in animals. All results were statistically significant. Conclusions Oestrogen therapy has a positive effect on vaginal wound healing. Future studies should determine whether oestrogen therapy has the potential to improve surgical outcomes.