title: Pharmacological treatment of pure stress urinary incontinence: a narrative review.
abstract: OBJECTIVE
  Treatment escalation from conservative directly to surgical in the management of pure stress urinary incontinence (SUI) reveals a gap for effective pharmacological treatments. The introduction of a drug therapy would fill this gap and widen the treatment options. Nevertheless, various pharmaceutical agents have been used off-label and are being investigated and becoming more widely available. In this review, we examined the latest published data regarding pharmacotherapy used in the treatment of SUI.
  
  
  METHODS
  We performed a literature review to evaluate the relevant studies pertaining to any pharmacotherapy used in the management of SUI, examining the English language literature.
  
  
  RESULTS
  Currently, no drug exists that is approved by the food and drug administration for the management of SUI. A few oral pharmacological agents are occasionally used off-label. Lack of proven efficacy and high incidence of bothersome side effects of these agents limit their use. Duloxetine, a serotonin norepinephrine reuptake inhibitor, represents a major therapeutic advance for the treatment of SUI based on findings from a number of controlled clinical trials.
  
  
  CONCLUSIONS
  Several pharmacological agents have been used off-label and investigated for safety and efficacy, but none has demonstrated sufficient effectiveness to receive widespread verification for its use in the treatment of SUI.
authors: Division of Urology, Department of Surgery, Al-Adan Hospital, Kuwait, Kuwait, drmalallah@icloud.com.
authors: Mariam A
authors: MA
authors: Malallah
authors: Tariq F
authors: TF
authors: Al-Shaiji
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D036145:Ginsenosides / Q000627:therapeutic use; D006801:Humans; D056687:Off-Label Use; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000627:therapeutic use*; D014550:Urinary Incontinence, Stress / Q000188:drug therapy*
chemical_list: D000316:Adrenergic alpha-Agonists; D000318:Adrenergic beta-Agonists; D000319:Adrenergic beta-Antagonists; D000929:Antidepressive Agents, Tricyclic; D036145:Ginsenosides; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; C055305:ginsenoside Rh2; D000068736:Duloxetine Hydrochloride
references: BJOG. 2004 Dec;111 Suppl 1:10-4
references: 15663150
references: Br J Obstet Gynaecol. 1999 Jul;106(7):711-8
references: 10428529
references: Neurourol Urodyn. 2002;21(2):167-78
references: 11857671
references: Acta Pharmacol Sin. 2008 Sep;29(9):1109-18
references: 18718180
references: Int Urogynecol J. 2010 Jan;21(1):5-26
references: 19937315
references: Urology. 1987 Oct;30(4):398-403
references: 3310369
references: Am J Chin Med. 2014;42(4):817-31
references: 25004877
references: BJOG. 2004 Mar;111(3):249-57
references: 14961887
references: Obstet Gynecol. 2001 Sep;98(3):398-406
references: 11530119
references: Life Sci. 2002 Aug 2;71(11):1227-36
references: 12106588
references: Neuropsychopharmacology. 2001 Dec;25(6):871-80
references: 11750180
references: BJU Int. 1999 Dec;84(9):923-47
references: 10571617
references: BJU Int. 2004 Feb;93(3):311-8
references: 14764128
references: Am J Chin Med. 2013;41(2):231-52
references: 23548116
references: BJU Int. 2004 Jan;93(1):78-83
references: 14678373
references: Urol Clin North Am. 1995 Aug;22(3):557-77
references: 7645157
references: Int J Gynaecol Obstet. 2000 Oct;71(1):39-44
references: 11044540
references: J Urol. 1997 Sep;158(3 Pt 1):875-80
references: 9258103
references: BJU Int. 2004 Feb;93(3):324-30
references: 14764130
references: Br J Obstet Gynaecol. 1983 Oct;90(10):919-33
references: 6684949
references: Br Med J. 1980 Nov 8;281(6250):1243-5
references: 7427654
references: Cochrane Database Syst Rev. 2001;(1):CD001407
references: 11279716
references: World J Urol. 1997;15(5):268-74
references: 9372577
references: Scand J Urol Nephrol. 1979;13(1):5-10
references: 570300
references: Obstet Gynecol. 1996 Nov;88(5):745-9
references: 8885906
references: Am J Obstet Gynecol. 1981 Dec 1;141(7):817-20
references: 7198384
references: Drugs. 1988 Apr;35(4):477-94
references: 3292211
references: Cochrane Database Syst Rev. 2003;(2):CD001405
references: 12804406
references: Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(3):145-50
references: 9745973
references: J Clin Epidemiol. 2000 Nov;53(11):1150-7
references: 11106889
references: BJU Int. 2004 May;93(7):1115
references: 15142177
references: J Urol. 2005 May;173(5):1647-53
references: 15821528
references: J Pharmacol Exp Ther. 1995 Aug;274(2):1014-24
references: 7636716
references: Curr Med Res Opin. 2003;19(6):485-90
references: 14594520
references: Urology. 1975 May;5(5):624-5
references: 1129889
references: Maturitas. 2000 Aug 31;36(2):83-92
references: 11006496
references: Int J Mol Sci. 2012 Nov 22;13(12):15523-35
references: 23443079
references: Acta Obstet Gynecol Scand. 1984;63(3):257-60
references: 6730943
references: J Urol. 2003 Oct;170(4 Pt 1):1259-63
references: 14501737
references: N Engl J Med. 2000 Dec 21;343(25):1826-32
references: 11117973
references: Am J Obstet Gynecol. 2002 Jul;187(1):40-8
references: 12114886
references: J Urol. 1974 Jul;112(1):81-8
references: 4601044
references: Obstet Gynecol. 2001 Jan;97(1):116-20
references: 11152919
references: Minerva Ginecol. 2014 Oct;66(5):469-78
references: 25078140
references: Nat Rev Urol. 2012 Nov;9(11):638-51
references: 23027065