{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:16:13Z","timestamp":1787919373626,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether vaginal oestrogen therapy improves outcomes after prolapse surgery in postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Double\u2010blind, randomised, placebo\u2010controlled trial with 12\u2009month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multicentre, 22 hospitals in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Postmenopausal women with POP\u2010Q stage \u2265\u20092 scheduled for primary native\u2010tissue prolapse repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women were randomised (1:1) to vaginal oestriol cream (1\u2009mg\/g) or identical placebo, started 4\u20136\u2009weeks preoperatively and continued to 12\u2009months postoperatively (twice\u2010weekly maintenance).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Subjective improvement in prolapse symptoms at 12\u2009months postoperatively, defined as \u201cmuch\u201d or \u201cvery much\u201d improved on the Patient Global Impression of Improvement (PGI\u2010I) scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total 293 women participated, 57 women dropped out. At 12\u2009months, 92% of women in the oestrogen group versus 80% in the placebo group reported improvement on the PGI\u2010I scale (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Pelvic floor\u2010related quality of life was better in the oestrogen group (median score PFDI\u201020: 17 vs. 25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and fewer women reported discomfort\/pain (EQ\u20105D\u20105L: 61% vs. 77%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Anatomical outcomes, composite surgical success, sexual function and reintervention rates did not differ between groups. The cream was easy to use; 80% would use it for 1 year if it provided meaningful health benefits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perioperative vaginal oestrogen improved patient\u2010reported outcomes and pelvic floor\u2010related quality of life at 12\u2009months, without affecting anatomical outcomes. These findings support discussing vaginal oestrogen as an adjunctive treatment option in shared decision\u2010making with postmenopausal women undergoing primary prolapse surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      NL\u2010OMON55535,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.onderzoekmetmensen.nl\/en\/trial\/55535\">https:\/\/www.onderzoekmetmensen.nl\/en\/trial\/55535<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70311","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:17:11Z","timestamp":1787915831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vaginal Oestrogen Therapy for Postmenopausal Women Undergoing Prolapse Surgery: A Multicentre Double\u2010Blind Randomised Placebo\u2010Controlled Clinical Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-9495","authenticated-orcid":false,"given":"Eva V.","family":"Vodegel","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Amsterdam University Medical Centre \u2013 Location AMC, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-1110","authenticated-orcid":false,"given":"Krista","family":"van Rest","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Amsterdam University Medical Centre \u2013 Location AMC, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Speksnijder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Amphia Ziekenhuis  Breda the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-1710","authenticated-orcid":false,"given":"Astrid","family":"Vollebregt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Spaarne Gasthuis  Hoofddorp the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2778-5709","authenticated-orcid":false,"given":"Albert","family":"Adriaanse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Noordwest Ziekenhuisgroep  Alkmaar the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0517-454X","authenticated-orcid":false,"given":"Eveline J.","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Tergooi  Hilversum the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Gerards","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Flevoziekenhuis  Almere the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbert","family":"Spaans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Maastricht University Medical Centre  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Sikkema","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Ziekenhuisgroep Twente  Almelo the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joggem","family":"Veen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Maxima Medisch Centrum  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Vernooij","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Diakonessenhuis  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5312-9682","authenticated-orcid":false,"given":"Marinus","family":"van der Ploeg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Martini Ziekenhuis  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3069-6382","authenticated-orcid":false,"given":"Jan\u2010Paul W. R.","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Amsterdam University Medical Centre \u2013 Location AMC, University of Amsterdam  Amsterdam the Netherlands"},{"name":"Bergman Clinics \u2013 Vrouw  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EVA Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.1097\/00006250-201711000-00052","article-title":"Pelvic Organ Prolapse","volume":"130","author":"Practice Bulletin No. 185","year":"2017","journal-title":"Obstetrics and Gynecology"},{"issue":"4","key":"e_1_2_13_3_1","first-page":"239","article-title":"Body Image and Sexuality in Women With Pelvic Organ Prolapse","volume":"29","author":"Zielinski R.","year":"2009","journal-title":"Urologic Nursing"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2018.03.007"},{"issue":"7","key":"e_1_2_13_5_1","article-title":"Oestrogen Therapy for Treating Pelvic Organ Prolapse in Postmenopausal Women","volume":"7","author":"Taithongchai A.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0136265"},{"key":"e_1_2_13_7_1","article-title":"Oestrogen Therapy for Urinary Incontinence in Post\u2010Menopausal Women","volume":"10","author":"Cody J. 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