Sugaya Kimio, Sekiguchi Yuki, Satoh Tomoya, Shiroma Kazuo, Kadekawa Katsumi, Ashitomi Katsuhiro, Nishijima Saori
Department of Urology, Kitakami Central Hospital, Chatan, Okinawa, Japan; Southern Knights' Laboratory LLP, Okinawa, Japan.
Int J Urol. 2014 Oct;21(10):1022-5. doi: 10.1111/iju.12513. Epub 2014 Jun 16.
To investigate whether the anticholinergic agent, propiverine hydrochloride, is clinically effective for stress urinary incontinence.
The participants were adult female patients with the chief complaint of stress incontinence. Propiverine (20 mg once daily) was given for 8 weeks. If the response was inadequate after 4 weeks of treatment, the dose was increased to 40 mg/day. Before and after 4 and 8 weeks of treatment, lower urinary tract symptoms were assessed. The urethral pressure and blood catecholamine levels were also measured.
A total of 37 patients (mean age 69 ± 11 years) were enrolled, including 15 patients with stress incontinence and 22 with mixed incontinence. The number of episodes of stress incontinence decreased significantly from 2.6 ± 2.3 times per day to 1.3 ± 2.2 times per day after 4 weeks, and 0.4 ± 0.6 times per day after 8 weeks. The daytime and night-time frequency of urination, and quality of life score showed significant improvement. The maximum urethral closing pressure and the functional urethral length increased significantly after treatment, but blood catecholamine levels, blood pressure and pulse rate at 8 weeks were not significantly different from those at baseline.
Propiverine could be an effective drug for stress urinary incontinence by increasing urethral closing pressure without increasing blood catecholamine levels.
研究抗胆碱能药物盐酸丙哌维林对压力性尿失禁是否具有临床疗效。
参与者为以压力性尿失禁为主诉的成年女性患者。给予丙哌维林（每日一次，20毫克），疗程8周。若治疗4周后反应欠佳，则将剂量增至40毫克/天。在治疗4周和8周前后，评估下尿路症状。同时测量尿道压力和血儿茶酚胺水平。
共纳入37例患者（平均年龄69±11岁），其中压力性尿失禁患者15例，混合性尿失禁患者22例。压力性尿失禁发作次数在4周后从每天2.6±2.3次显著降至1.3±2.2次，8周后降至每天0.4±0.6次。白天和夜间排尿频率以及生活质量评分均有显著改善。治疗后最大尿道闭合压和功能性尿道长度显著增加，但8周时血儿茶酚胺水平、血压和脉搏率与基线相比无显著差异。
丙哌维林可通过增加尿道闭合压而不增加血儿茶酚胺水平，成为治疗压力性尿失禁的有效药物。
