Pharmacological treatment of pure stress urinary incontinence: a narrative review

Int Urogynecol J. 2015 Apr;26(4):477-85. doi: 10.1007/s00192-014-2512-9. Epub 2015 Jan 29.

Abstract

Introduction and hypothesis: 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.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-Agonists / therapeutic use
  • Adrenergic beta-Agonists / therapeutic use
  • Adrenergic beta-Antagonists / therapeutic use
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Duloxetine Hydrochloride / therapeutic use*
  • Estrogen Replacement Therapy
  • Ginsenosides / therapeutic use
  • Humans
  • Off-Label Use
  • Serotonin and Noradrenaline Reuptake Inhibitors / therapeutic use*
  • Urinary Incontinence, Stress / drug therapy*

Substances

  • Adrenergic alpha-Agonists
  • Adrenergic beta-Agonists
  • Adrenergic beta-Antagonists
  • Antidepressive Agents, Tricyclic
  • Ginsenosides
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • ginsenoside Rh2
  • Duloxetine Hydrochloride