Neurobiology of stress urinary incontinence: new insights and implications for treatment.
Stress urinary incontinence (SUI) is a significant problem for millions of women, many of whom remain untreated for years, sometimes for life. One reason for this is the lack of effective pharmacologic therapy. The drugs used for urge incontinence have little or no effect on leakage occurring without detrusor contraction under conditions of increased intra-abdominal pressure. Recent studies suggest that extrinsic urethral sphincter closure may be controlled by enhancing neurotransmission in pudendal pathways. A new agent, duloxetine, which inhibits serotonin-norepinephrine re-uptake in these pathways, is now in clinical trials and appears to be the first effective pharmacologic therapy for SUI.
Cardozo
L
L
Department of Urogynaecology, King's College Hospital, 8 Devonshre Place, London W1G 6HP, UK. lcardozo@compuserve.com
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride; D005260:Female; D005836:Genitalia, Female / Q000294:innervation; D006176:Gynecology / Q000639:trends; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D009435:Synaptic Transmission; D013876:Thiophenes / Q000627:therapeutic use; D014521:Urethra / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000503:physiopathology*
D018759:Adrenergic Uptake Inhibitors; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes