Clinical Pharmacology of the Lower Urinary Tract

Lose, Gunnar; Andersen, Jens T.

doi:10.1159/000472568

Cited by 10 publications

(4 citation statements)

References 45 publications

(83 reference statements)

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“…peripress) and muscle relaxants can provoke stress incontinence because of the relaxing effect on the sphincter mechanism. A lot of different medications such as narcotics, calcium antagonists, tricyclic antidepressants and phenothiazides relax the detrusor which might provoke retention with overflow incontinence (15).…”

Section: General Advicementioning

confidence: 99%

“…This treatment aims at improving the urethral closure mechanism (15). The intraurethral pressure can rise as a result of stimulation of the alphareceptors in the smooth muscles of the bladder neck and proximal urethra.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…The aim of the treatment is relaxation of the detrusor. Many different drugs have been used (15). The most investigated drugs belong to the main groups: 1) anticholinergics, 2) drugs with combined effect, 3) antidepressants and 4) Desmopressin (minirin).…”

Section: Hypnotherapy and Acupuncturementioning

confidence: 99%

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Management of stress and urge urinary incontinence in women

Glavind¹,

Mouritsen²,

Lose³

1999

Acta Obstet Gynecol Scand

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Urinary incontinence (UI) constitutes a very common problem in all age groups but most frequently in elderly women. In a review made by Hampel et al. a prevalence of about 25% was found in middle-aged women (30-60 years) rising to 55.7% in institutionalized and impaired women (1).Incontinence adversely affects quality of life and, despite its prevalence, up to 70% of the affected individuals do not seek help for incontinence, because of embarrassment, unawareness that help is available, low expectations or because the symptom is not considered as a problem. When individuals do seek help, evidence exists that health professionals are hesitant or ill prepared to discuss, diagnose or treat the problem (2, 3). UI affects the 'quality of life' to a large extent and, furthermore, has great impact on health-care costs (4, 5).In many instances simple advice or conservative treatment can be effective. More than 50% of patients can be treated using 'minimal care' management (6). The treatment of UI must always relate to the needs of the patient and to the impact on the quality of life.Abbreviation: UI: urinary incontinence.C Acta Obstet Gynecol Scand 78 (1999) This survey deals with the management of stress and urge incontinence in women. General adviceThere are a number of simple regulations and advice that can improve the situation (Table I). In elderly women the capacity of the bladder is reduced, hence large fluid intake of e.g. 3-4 litres can result in frequency and urge incontinence, this will appear in a urinary diary. Many women void at very large intervals that may lead to overflow incontinence. Voiding with 3-4 hours interval should be taught. Timed voiding every second hour cured 79% of 20 women with functional stress incontinence (7). Bladder training reduced the number of incontinence episodes by 57% in 123 women with both stress and urge incontinence (8). Timed voiding and treatment of urinary tract infections in geriatric patients cured 55% of the women (9).It is important to take your time to void and especially for patients with poor bladder emptying, residual urine may be reduced by double or triple voiding, that is voiding with intervals of at least one minute where you rise from the toilet two or three times (10).For old and immobile patients alternative facilities in the form of a bed pan can be helpful.

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Section: General Advicementioning

confidence: 99%

Section: Pharmacological Treatmentmentioning

confidence: 99%

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Management of stress and urge urinary incontinence in women

Glavind¹,

Mouritsen²,

Lose³

1999

Acta Obstet Gynecol Scand

Self Cite

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“…Many investigators have shown that treatment with a-adrenoceptor-stimulating drugs may improve stress in continence by increasing the urethral closure pressure [8]. Information is sparse, however, concerning the long term consequences for patients who primarily receive pharmacologic treatment for stress incontinence.…”

Section: Introductionmentioning

confidence: 99%

Does Medical Therapy Cure Female Stress Incontinence?

Lose

Diernaes²,

Rix³

1989

Urol Int

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Forty-four consecutive female patients, who were scheduled for operation for genuine stress incontinence but instead treated pharmacologically with an Α-agonist or placebo for 3–4.5 months, were evaluated after a median observation period of 30 months. Ten patients (23%) underwent colposuspension. Fourteen patients (32%) claimed to be continent or so much improved that further treatment was considered unnecessary by the patients themselves. Of the remaining 20 patients who still claimed to have stress incontinence, 11 (25%) preferred to resume the pharmacological treatment whereas 9 patients (20%) had not decided whether they wanted further treatment. These results suggest that some operations for stress incontinence may be avoided by introduction of a standard trial of medical therapy prior to intended surgical intervention.

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Clinical evaluation of routine urodynamic investigations in prostatism

Jensen

1989

Neurourology and Urodynamics

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The present survey is based on the following papers: I. Jensen KM-E, Jorgensen JB, Mogensen P (1985): Reproducibility of uroflowmetry variables in elderly males. Urol Res 13:237-239. 11. Jorgensen JB, Jensen KM-E, Bille-Brahe NE, Mogensen P (1986): Uroflowmetry in asymptomatic elderly males. Br J Urol 58:390-395. 111. Jensen KM-E, Jorgensen JB, Mogensen P, Bille-Brahe NE (1986): Some clinical aspects of uroflowmetry in elderly males. A population survey. Scand J Urol Nephrol 20:93-99. IV. Jensen KM-E, Jorgensen JB, Mogensen P (1987): Relationship between urinary flow curve patterns and symptomatology in elderly males. Scand J Urol Nephrol Suppl 104:69-71. V. Jensen KM-E, Jorgensen JB, Mogensen P (1988): Urodynamics in prostatism. I. Prognostic value of uroflowmetry. Scand J Urol Nephrol 22:109-117 and [Suppl] 114:63-71. VI. Jensen KM-E, Jorgensen JB, Mogensen P (1988): Urodynamics in prostatism. 11. Prognostic value of pressure-flow study combined with stop-flow test. Scand J Urol Nephrol Suppl 114:72-77. VII. Jensen KM-E, Jfirgensen JB, Mogensen P (1988): Urodynamics in prostatism. 111. Prognostic value of medium-fill water cystometry. Scand J Urol Nephrol [Suppl] 114:78-83. VIII. Jensen KM-E, Jorgensen JB, Mogensen P (1988): Urodynamics in prostatism. IV. Search for prognostic patterns as evaluated by linear discriminant analysis. Scand J Urol Nephrol [Supplj 114:84-86.

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Clinical Pharmacology of the Lower Urinary Tract

Cited by 10 publications

References 45 publications

Management of stress and urge urinary incontinence in women

Management of stress and urge urinary incontinence in women

Does Medical Therapy Cure Female Stress Incontinence?

Clinical evaluation of routine urodynamic investigations in prostatism

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