30 stress incontinent women with none or mild-degree suspension defects were selected for conservative therapy with an alpha-adrenergic stimulant (midodrine), a chohnesterase inhibitor (distigmine bromide), a tricyclic antidepressant (imipramine) and estriol (Triodurin®). The effect of these drugs on the urethral pressure profile parameters such as maximum urethral pressure and the planimetric index of the continence area were compared with parameters before and after pubovaginal sling operation, before and after single drugs and drug combinations. The medication period in each case was 4 weeks. While the profile area of the continence zone increased after successful suspension surgery by 45%, the increase was 9% after midodrine, 8.9% after imipramine, 7.3% after estriol and 0.48% after distigmine bromide. The maximum urethral pressure showed an increase of the mean values by 8.1% after surgery, 8.3% after midodrine, 7.9% after imipramine, 3.5% after estriol and 3.5% after distigmine bromide. Subjectively, adjuvant therapy, i.e. estriol plus midodrine and estriol plus imipramine, was highly favored by the patients; the urodynamic assessment, however, failed to show significant advantages versus single drug therapy.

Keywords:
Stress incontinence, women, Urethral pressure profile changes, Pubovaginal sling operation, Midodrine, Distigmine bromide, Imipramine, Estriol
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© 1983 S. Karger AG, Basel
1983
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