Prostaglandins for enhancing detrusor function after surgery for stress incontinence in women.

Sixty-nine women with a clinically and urodynamically proven diagnosis of genuine stress incontinence underwent urethropexy in the form of the revised Pereyra procedure (n = 28) or Burch colposuspension (n = 41). Postoperatively the patients were assigned randomly to one of three study groups. Group 1 received a daily saline injection to the bladder (control group, n = 24), group 2 received daily intravesical injections of 250 mg of prostaglandin F2 alpha (PGF2 alpha) (n =23), and group 3 received a daily 10-mg PGE2 (PGE2) vaginal suppository (n = 22). The patients' suprapubic catheter was removed once the postvoiding residual urine volume was less than or equal to 50 mL. Both PGE2 and PGF2 significantly reduced the length of time required for postoperative bladder drainage after both the Burch and Pereyra procedures as compared to that in the control group (P less than .05). Hospital stay and bacteriuria were reduced as well in women receiving postoperative prostaglandins as compared to the control group. Clinically there were no differences between PGE2 and PGF2 alpha. Both produced no side effects, were well tolerated by the patients and were effective in reducing both the number of days required for bladder catheterization and the incidence of significant bacteriuria when administered after the surgical procedures.