Stress urinary incontinence: A closer look at nonsurgical therapies
OBG Management. 2003 September;15(09):40-51
September 1, 2003|ObGyn
Author and Disclosure Information
This pervasive condition has spawned a host of treatments, from conservative measures like pelvic floor rehabilitation to cutting-edge modalities such as radiofrequency therapy. In this discussion, a panel of experts compares the less invasive options and offers pearls on evaluating and counseling patients and selecting appropriate treatments.
TABLE 1
Drugs that affect stress urinary incontinence
| WORSEN INCONTINENCE |
| Alpha blockers |
|
| Diuretics |
| IMPROVE INCONTINENCE |
| Alpha agonists |
|
| Mixed-effect agents |
|
| Estrogens (local administration) |
TABLE 2
Recommended therapeutic agents
| DRUG | DOSAGE |
|---|---|
| STRESS INCONTINENCE | |
| Phenylpropanolamine (Dimetapp) | 25-50 mg every 6 to 8 hours |
| Pseudoephedrine (Sudafed) | 60 mg every 6 to 8 hours |
| Imipramine (Tofranil) | 25-100 mg at bedtime |
| Estrogen intravaginal cream (Estrace, Premarin) | 2 g twice weekly |
| URGE INCONTINENCE | |
| Oxybutynin | |
| • Ditropan | 2.5-5 mg 3 times a day |
| • Ditropan XL | 5-15 mg daily |
| • Oxytrol (transdermal) | 3.9 mg patch twice weekly |
| Flavoxate (Urispas) | 100-200 mg 3 or 4 times a day |
| Tolterodine (Detrol LA) | 4 mg daily |
| Hyoscyamine (Levbid) | 0.375 mg 2 times a day |
| Imipramine (Tofranil) | 25-100 mg at bedtime |
| Estrogen intravaginal cream (Estrace, Premarin) | 2 g twice weekly |
| NOCTURIA | |
| Desmopressin (DDAVP) | 0.1-0.4 mg at bedtime |
| OVERFLOW INCONTINENCE | |
| Bethanechol (Urecholine) | 20-100 mg every 6 hours for underactive detrusor causing overflow incontinence |
The authors report no financial relationship with any companies whose products are mentioned in this article.
