Effect of combined treatment with phenylpropanolamine and estriol, compared with estriol treatment alone, in postmenopausal women with stress urinary incontinence

• Published in: Gynecologic and obstetric investigation Vol. 30; no. 1; p. 37
• Main Authors: Ahlström, K, Sandahl, B, Sjöberg, B, Ulmsten, U, Stormby, N, Lindskog, M
• Format: Journal Article
• Language: English
• Published: Switzerland 1990
• Subjects: Double-Blind Method; Drug Therapy, Combination; Estriol - administration & dosage; Estriol - therapeutic use; Female; Humans; Menopause; Middle Aged; Phenylpropanolamine - administration & dosage; Phenylpropanolamine - therapeutic use; Urinary Incontinence, Stress - drug therapy; Urodynamics - physiology
• ISSN: 0378-7346
• DOI: 10.1159/000293211

Twenty-nine postmenopausal women with slight to severe stress urinary incontinence and estrogen deficiency symptoms in the urogenital tract were treated with estriol, p.o. 4 mg once daily, and either phenylpropanolamine (PPA), p.o. 50 mg twice daily, or placebo for periods of 6 weeks according to a randomized double-blind crossover schedule. At urodynamic recordings the maximum urethral closure pressure increased by 22% with combined treatment (p less than 0.001) and an additional effect of PPA to estriol was shown (p = 0.022). The pressure transmission ratio increased, by about 15%, with both treatments (p less than 0.07). The number of leakage episodes was reduced by 28% with combined treatment (p = 0.007), but not with estriol alone (p = 0.08). Both combined treatment and estriol alone reduced significantly (p less than 0.01) the urinary incontinence complaints. Twelve women (43%) preferred combined treatment, while 7 (25%) preferred estriol alone. In women with initially slight to very severe urine loss, combined treatment reduced also (p = 0.02) the amount of urine loss, measured at a standardized physical stress test. Signs of estrogen deficiency in vulva, vagina and urethra were reduced, 75% (p less than 0.001) or 65% (p = 0.001) with estriol given in combination with PPA or alone. Maturation index of both urethral and vaginal epithelium displayed significant changes. It is concluded that the combined treatment, PPA + estriol, by affecting both the muscular and mucosal factor of the urethra, is more effective than estriol alone for treatment of female stress urinary incontinence in the postmenopausal ages.