What is the role of alpha agonists in urinary incontinence treatment?

Updated: Jan 22, 2021
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Alpha agonists, such as midodrine (Pro-Amatine) or pseudoephedrine (Sudafed), may improve symptoms of mild stress incontinence by increasing intrinsic urethral tone. Phenylpropanolamine hydrochloride (Entex LA, Ornade) was the first-line pharmacologic therapy for women with stress incontinence; however, it has been recalled from the US market.

The subjective improvement and cure rates with pseudoephedrine are similar to those conferred by phenylpropanolamine, which resulted in few cures or dryness (0-14%) but provided subjective improvement in 20-60% of women. In adults, pseudoephedrine dosing is 60 mg qid, or 120 mg bid with the extended-release form. Pediatric dosing has not been established. Pseudoephedrine is also a pregnancy category C drug.

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