TY - JOUR
T1 - The effects of oestrogen on vaginal wound healing
T2 - A systematic review and meta-analysis
AU - Vodegel, Eva V.
AU - Kastelein, Arnoud W.
AU - Jansen, Charlotte H. J. R.
AU - Limpens, Jacqueline
AU - Zwolsman, Sandra E.
AU - Roovers, Jan-Paul W. R.
AU - Hooijmans, Carlijn R.
AU - Guler, Zeliha
N1 - Funding Information: Project: ?Synthesis of Evidence, more evidence with less animals? from ZonMW (Project number: 114024902) for funding the collaboration with SYRCLE (SYstematic Review Center for Laboratory animal Experimentation). Publisher Copyright: © 2021 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.
PY - 2022/1
Y1 - 2022/1
N2 - 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.
AB - 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.
KW - TGF-β1
KW - collagen synthesis
KW - granulation
KW - inflammatory response
KW - neovascularisation
KW - oestrogen
KW - pelvic organ prolapse
KW - re-epithelialisation
KW - tissue strength
KW - vaginal surgery
KW - wound contraction
KW - wound healing
UR - http://www.scopus.com/inward/record.url?scp=85117000330&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/nau.24819
DO - https://doi.org/10.1002/nau.24819
M3 - Review article
C2 - 34643282
SN - 0733-2467
VL - 41
SP - 115
EP - 126
JO - Neurourology and urodynamics
JF - Neurourology and urodynamics
IS - 1
ER -