Medikament�se Therapie der weiblichen Harninkontinenz

Abstract

Drug treatment for female urinary incontinence requires a thorough knowledge of the differential diagnosis and pathophysiology of incontinence as well as of the pharmacological agents employed. Pharmacotherapy has to be tailored to suit the incontinence subtype and should be carefully balanced according to efficacy and side effects of the drug. Women with urge incontinence require treatment that relaxes or desensitizes the bladder (antimuscarinics, estrogens, alpha-blockers, beta-mimetics, botulinum toxin A, resiniferatoxin, vinpocetine), whereas patients with stress incontinence need stimulation and strengthening of the pelvic floor and external sphincter (alpha-mimetics, estrogens, duloxetine). Females with overflow incontinence need reduction of outflow resistance (baclofen, alpha-blockers, intrasphincteric botulinum toxin A) and/or improvement of bladder contractility (parasympathomimetics). If nocturia or nocturnal incontinence are the major complaints, control of diuresis is obtained by administration of the ADH analogue desmopressin. Future developments will help to further optimize the pharmacological therapy for female urinary incontinence.

Efficacy of Alpha Blockers in Relieving Symptoms of JJ Stent

“…Alpha blockers are routinely prescribed to patients in postoperative period of ureterorenoscopy because it reduces the colicky episode, reduces JJ stent related symptoms and increases the passage of residual calculi [31]. Important mode of action of alpha blockers is to relieve voiding symptoms of JJ stents in alpha blockers by decreasing frequency, urgency and urge incontinence and this effect has been well proved by urodynamics studies [32].…”

Urogynäkologie. Belastungsinkontinenz

“…" Östrogene " Alpha-Sympathomimetika " Duloxetin [5,6] Merke Eine urodynamische Untersuchung vor einer operativen Maßnahme ist notwendig.…”

Intravesikale Therapie der überaktiven Blase

“…Trotz deut li cher Fort schrit te auf dem Ge biet der An ti cho li ner gi ka, die zu ei ner deut li chen Re duk ti on von Ne ben wir kungen und ei ner Ver bes se rung der sub jek tiven Ver träg lich keit der The ra pie ge führt ha ben, zei gen Lang zeit stu di en, dass nur ca. 20 der Pa ti en ten die The ra pie für >1 Jahr fort füh ren [12]. Haupt ur sa chen für einen Ab bruch der Be hand lung stellen In ef fek ti vi tät und man geln de Ver träg-lich keit dar.…”