, Volume 1, Issue 2, pp 74-79

Stress urinary incontinence in postmenopausal women treated with oral estrogen (estriol) and an alpha-adrenoceptor-stimulating agent (phenylpropanolamine): A randomized double-blind placebo-controlled study

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Twenty-eight postmenopausal women with objectively verified stress incontinence completed a randomized double-blind placebo-controlled study. After an initial 4 weeks of placebo treatment the patients received either oral estriol (E3) (4mg daily) or oral phenylpropanolamine (PPA) (50 mg b.i.d.) alone for 4 weeks, followed by another 4 weeks of treatment with the two active drugs in combination.

Subjectively, 14 of 15 patients preferred PPA to placebo (P<0.001), 9 of 12 patients preferred E3 to placebo (P=0.011), and 10 of 14 patients preferred E3 + PPA to E3 (P=0.006). Two patients became continent on PPA, 2 on E3, and 12 of 28 patients on combined treatment. PPA gave a significant decrease in urine loss when compared with placebo (P=0.023), and the combined treatment of PPA + E3 also gave a reduction in urine loss when compared with placebo (P=0.022). It is concluded that estriol 4mg daily and PPA 50 mg b.i.d. are effective in the treatment of stress urinary incontinence in postmenopausal women. The enhanced effect of combined treatment is moderate and of questionable importance.