Pharmacotherapy in Stress Urinary Incontinence; A Literature Review

• Published in: Current urology reports Vol. 25; no. 7; pp. 141 - 148
• Main Authors: Tabei, Seyed Sajjad, Baas, Wesley, Mahdy, Ayman
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-07-2024
• Subjects: Duloxetine Hydrochloride - therapeutic use; Female; Humans; Male; Medicine; Medicine & Public Health; Nephrology; Review; Topical Collection on Female and Male Incontinence and Genitourinary Reconstruction; Urinary Incontinence, Stress - drug therapy; Urology; Urinary incontinence; Pharmacotherapy; Stress urinary incontinence; Duloxetine; Drug therapy; Urinary incontinence, stress
• ISSN: 1527-2737; 1534-6285; 1534-6285
• DOI: 10.1007/s11934-024-01205-9

Purpose of Review
Stress urinary incontinence (SUI) is a commonly observed condition in females, as well as in males who have undergone prostatectomy. Despite the significant progress made in surgical techniques, pharmacotherapy has not yielded substantial outcomes within the clinical domain. This review aims to present a comprehensive overview of the existing pharmacotherapy options for stress urinary incontinence (SUI) and the emerging therapeutic targets in this field.
Recent Findings
One meta-analysis demonstrated that α-adrenergic medications are more efficacious in improving rather than curing SUI symptoms. One trial showed reduced pad weight gain with PSD-503, a locally administered α-adrenergic receptor agonist. New data show that duloxetine’s risk outweighs its benefits. One small-scale trial was found to support the use of locally administered estriol in improving subjective outcomes. Emerging targets include serotonin 5HT
2C
agonists, selective inhibitors of norepinephrine uptake, and myostatin inhibitors.
Summary
Only one of the evaluated drugs, duloxetine, has been approved by some countries. Currently, trials are evaluating novel targets. Systemic adverse effects such as gastrointestinal upset with duloxetine and orthostatic hypotension with
α
-adrenoceptor agonists have hampered the efficacy of drugs used to treat SUI in women and men.