title: Effect of combined treatment with phenylpropanolamine and estriol, compared with estriol treatment alone, in postmenopausal women with stress urinary incontinence.
abstract: Twenty-nine postmenopausal women with slight to severe stress urinary incontinence and estrogen deficiency symptoms in the urogenital tract were treated with estriol, p.o. 4 mg once daily, and either phenylpropanolamine (PPA), p.o. 50 mg twice daily, or placebo for periods of 6 weeks according to a randomized double-blind crossover schedule. At urodynamic recordings the maximum urethral closure pressure increased by 22% with combined treatment (p less than 0.001) and an additional effect of PPA to estriol was shown (p = 0.022). The pressure transmission ratio increased, by about 15%, with both treatments (p less than 0.07). The number of leakage episodes was reduced by 28% with combined treatment (p = 0.007), but not with estriol alone (p = 0.08). Both combined treatment and estriol alone reduced significantly (p less than 0.01) the urinary incontinence complaints. Twelve women (43%) preferred combined treatment, while 7 (25%) preferred estriol alone. In women with initially slight to very severe urine loss, combined treatment reduced also (p = 0.02) the amount of urine loss, measured at a standardized physical stress test. Signs of estrogen deficiency in vulva, vagina and urethra were reduced, 75% (p less than 0.001) or 65% (p = 0.001) with estriol given in combination with PPA or alone. Maturation index of both urethral and vaginal epithelium displayed significant changes. It is concluded that the combined treatment, PPA + estriol, by affecting both the muscular and mucosal factor of the urethra, is more effective than estriol alone for treatment of female stress urinary incontinence in the postmenopausal ages.
authors.affiliation: Department of Obstetrics and Gynecology, Kristianstad Hospital, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Ahlström
authors.forename: B
authors.initials: B
authors.lastname: Sandahl
authors.forename: B
authors.initials: B
authors.lastname: Sjöberg
authors.forename: U
authors.initials: U
authors.lastname: Ulmsten
authors.forename: N
authors.initials: N
authors.lastname: Stormby
authors.forename: M
authors.initials: M
authors.lastname: Lindskog
mesh_terms: D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004964:Estriol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010665:Phenylpropanolamine / Q000008:administration & dosage / Q000627:therapeutic use*; D014550:Urinary Incontinence, Stress / Q000188:drug therapy*; D014563:Urodynamics / Q000502:physiology
chemical_list: D010665:Phenylpropanolamine; D004964:Estriol