[Drug therapy of female urinary incontinence].
Drug treatment for female urinary incontinence requires a thorough knowledge of the differential diagnosis and pathophysiology of incontinence as well as of the pharmacological agents employed. Pharmacotherapy has to be tailored to suit the incontinence subtype and should be carefully balanced according to efficacy and side effects of the drug. Women with urge incontinence require treatment that relaxes or desensitizes the bladder (antimuscarinics, estrogens, alpha-blockers, beta-mimetics, botulinum toxin A, resiniferatoxin, vinpocetine), whereas patients with stress incontinence need stimulation and strengthening of the pelvic floor and external sphincter (alpha-mimetics, estrogens, duloxetine). Females with overflow incontinence need reduction of outflow resistance (baclofen, alpha-blockers, intrasphincteric botulinum toxin A) and/or improvement of bladder contractility (parasympathomimetics). If nocturia or nocturnal incontinence are the major complaints, control of diuresis is obtained by administration of the ADH analogue desmopressin. Future developments will help to further optimize the pharmacological therapy for female urinary incontinence.
Hampel
C
C
Urologische Klinik, Johannes-Gutenberg-Universität, Mainz. hampel@urologie.klinik.uni-mainz.de
Gillitzer
R
R
Pahernik
S
S
Melchior
S W
SW
Thüroff
J W
JW
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004224:Diterpenes / Q000627:therapeutic use; D004599:Electric Stimulation Therapy; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009122:Muscle Hypertonia / Q000175:diagnosis / Q000188:drug therapy; D014549:Urinary Incontinence / Q000175:diagnosis / Q000188:drug therapy*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000188:drug therapy*; D014563:Urodynamics / Q000187:drug effects*; D014748:Vinca Alkaloids / Q000627:therapeutic use
D000317:Adrenergic alpha-Antagonists; D000318:Adrenergic beta-Agonists; D004224:Diterpenes; D004967:Estrogens; D018727:Muscarinic Antagonists; D014748:Vinca Alkaloids; C013983:vinpocetine; C024353:resiniferatoxin; D019274:Botulinum Toxins, Type A; D003894:Deamino Arginine Vasopressin