International Surgery Journal | April-June 2016 | Vol 3 | Issue 2 Page 763 International Surgery Journal Khandelwal AK et al. Int Surg J. 2016 May;3(2):763-767 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Research Article Clinical evaluation and urodynamic study observation in post-menopausal female: a comparative study Atul K. Khandelwal 1 *, Shivani Khandelwal 2 , Vijoy Kumar 3 , Mahendra Singh 3 INTRODUCTION The lower urinary tract and female genital tract are arising from urogenital sinus. Both share a common embryologic origin and are sensitive to the effect of female steroid hormones. 1,2 It has been suggested that estrogen increases urethral closure pressure and improve pressure transmission to the proximal urethra, both promoting continence. 3 Atrophic changes may be caused by estrogen deficiency occurring after menopause. Important physiological and endocrinological changes occur due to ageing of ovary noticed around menopause and ultimately depletion of hormone level. Surgical menopause refers to indirect menopause caused by ABSTRACT Background: Menopause is an irreversible and age related phenomenon and serves as an objective sign of reproductive senescence. Atrophic changes within the urogenital tract may occur due to estrogen deficiency and is associated with genitourinary symptoms. Methods: A total of 66 women who attained natural and surgical menopause with more than twelve months with urogenital symptoms were selected for study. Results: Age of patients selected for study was between 35-70 years. Majority of the patients 52/66 (78.7%) were presented after minimum 5 yrs of menopause. Among genital symptoms vaginal discharge was significantly higher (p<0.05) in surgical group 46.87% (15/32) in comparison to 26.4% (9/34) natural menopause group. Other symptoms were more frequent in surgical menopause (p>0.05). Among urinary symptoms frequency was the most common symptom in both the groups, 15 (44.12%) in natural menopause and 22 (68.75%) in surgical menopause, more prevalent in surgical group. Urgency was seen in 38.23% in natural menopause and 56.25% in surgical menopause. Incontinence was present in 47.05% in natural menopause and 62.51% in surgical menopause. Among incontinence stress incontinence was most common in the groups, 20.59% in natural group and 37.5 % in surgical group, statistically significant in surgical group. Mixed incontinence was observed in 5.58% in natural menopause; statistically significant in surgical group. Prevalence of urge incontinence was observed more in natural menopause 20.59% and 3.12 % in surgical menopause. There was no statistically significant difference in uroflowmetry parameters between both the groups. In cystometry parameters, volume at first bladder sensation was significantly less in patients with urgency and urge incontinence in both groups. Maximum bladder capacity was less in detrusor overactivity in both the groups. Compliance was poor in patient with urge incontinence in both the groups. Conclusions: Hypoestrogenism could be an etiological factor in urogenital dysfunction in postmenopausal women with spontaneous menopause and surgical menopause. Keywords: Menopause, Natural, Surgical 1 Department of Urology, BPS Govt. Medical College, Khanpur Kalan, Sonepat, Haryana, India 2 Department of Obstetrics & Gynaecology, BPS Govt. Medical College, Khanpur Kalan, Sonepat, Haryana, India 3 Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India Received: 08 February 2016 Accepted: 11 February 2016 *Correspondence: Dr. Atul K. Khandelwal, E-mail: dratulkhandelwal@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20160492