University of Pennsylvania School of Medicine, Division of Urology, Philadelphia, USA.
Ann Med. 2011;43(6):461-76. doi: 10.3109/07853890.2011.564203. Epub 2011 Jun 3.
The impact of incontinence is felt by millions of people worldwide, with tremendous decrement in quality of life and enormous cost reaching billions of dollars. Urinary incontinence is defined as 'involuntary leakage of urine' and is categorized into two main types: urgency urinary incontinence (UUI) and stress urinary incontinence (SUI). Behavioral modifications and pharmacologic therapies, primarily antimuscarinic agents, are the mainstay of treatment for UUI. These drugs are moderately efficacious but have troublesome side-effects, the combination resulting in poor compliance and persistence with therapy. There are several agents on the market today, each with some variation in pharmacologic properties. Whether these translate into meaningful differences in clinical efficacy and tolerability remains a matter of debate. Treatment of SUI has seen little success with pharmacologic therapy. In Europe, duloxetine is approved for treatment of SUI with marginal success rates; this drug, although available in the United States for treatment of depression, is not approved for SUI. The search for newer and better pharmacologic options and novel therapies is on-going, fueled primarily by the high prevalence of bothersome incontinence and the tremendous number of health care dollars spent on current therapy. This review addresses pharmacologic options for treatment of urinary incontinence.
全球有数百万的人受到尿失禁的影响，生活质量严重下降，医疗费用高达数十亿美元。尿失禁被定义为“尿液不受控制地泄漏”，分为两种主要类型：急迫性尿失禁（UUI）和压力性尿失禁（SUI）。行为改变和药物治疗，主要是抗毒蕈碱药物，是 UUI 的主要治疗方法。这些药物有一定的疗效，但有令人困扰的副作用，导致治疗的依从性和持久性较差。目前市场上有几种药物，每种药物在药理学特性上都有一些差异。这些差异是否能转化为临床疗效和耐受性的显著差异，仍存在争议。药物治疗对 SUI 的效果甚微。在欧洲，度洛西汀被批准用于治疗 SUI，但成功率较低；这种药物虽然可用于治疗抑郁症，但未被批准用于治疗 SUI。人们正在寻找更新更好的药物治疗选择和新的治疗方法，这主要是由于烦人的尿失禁的高患病率和大量的医疗保健费用用于当前的治疗。这篇综述介绍了治疗尿失禁的药物治疗选择。
