Pharmacotherapy in Stress Urinary Incontinence; A Literature Review.

IF 2.5 2区医学 Q2 UROLOGY & NEPHROLOGY

Current Urology Reports Pub Date : 2024-07-01 Epub Date: 2024-05-10 DOI:10.1007/s11934-024-01205-9

Seyed Sajjad Tabei, Wesley Baas, Ayman Mahdy

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Abstract

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. 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.

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压力性尿失禁的药物治疗；文献综述。

审查目的：压力性尿失禁（SUI）是女性和男性前列腺切除术后的常见病。尽管手术技术取得了重大进展，但药物治疗在临床领域并未取得实质性成果。本综述旨在全面概述压力性尿失禁（SUI）的现有药物治疗方案以及该领域新出现的治疗目标：一项荟萃分析表明，α-肾上腺素能药物在改善而非治愈 SUI 症状方面更为有效。一项试验显示，PSD-503（一种局部给药α肾上腺素能受体激动剂）可减少尿垫重量的增加。新数据显示度洛西汀的风险大于其益处。一项小规模试验支持使用局部给药的雌三醇来改善主观疗效。新出现的靶点包括血清素 5HT2C 激动剂、去甲肾上腺素摄取选择性抑制剂和肌生成抑制剂。在已评估的药物中，只有度洛西汀一种已获得一些国家的批准。目前，相关试验正在评估新的靶点。全身性不良反应，如度洛西汀会引起胃肠道不适，α肾上腺素受体激动剂会导致正性低血压，这些都阻碍了用于治疗女性和男性 SUI 的药物的疗效。

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来源期刊

Current Urology Reports UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

3.80%

发文量

期刊介绍： This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.