Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
R. Bruce and Barbara Bracken Endowed Chair in Surgical Urology, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0589, Cincinnati, OH, 45267, USA.
Curr Urol Rep. 2024 Jul;25(7):141-148. doi: 10.1007/s11934-024-01205-9. Epub 2024 May 10.
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.
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 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.
压力性尿失禁（SUI）是女性以及前列腺切除术男性中常见的病症。尽管手术技术取得了重大进展，但在临床领域，药物治疗并未产生显著效果。本文旨在全面概述目前用于治疗压力性尿失禁（SUI）的药物治疗选择和该领域的新兴治疗靶点。
一项荟萃分析表明，α-肾上腺素能药物在改善而非治愈 SUI 症状方面更有效。一项试验表明，局部应用α-肾上腺素能受体激动剂 PSD-503 可减轻垫重量增加。新数据表明，度洛西汀的风险大于其益处。一项小规模试验发现局部应用雌三醇可改善主观结局。新兴靶点包括 5HT 激动剂、去甲肾上腺素摄取的选择性抑制剂和肌肉生长抑制素抑制剂。只有一种评估药物，度洛西汀，已被一些国家批准。目前，正在评估新的靶点。全身性不良反应，如度洛西汀引起的胃肠道不适和 α-肾上腺素能受体激动剂引起的直立性低血压，限制了用于治疗女性和男性 SUI 的药物的疗效。
