International Urogynecology Journal

, Volume 26, Issue 4, pp 477–485 | Cite as

Pharmacological treatment of pure stress urinary incontinence: a narrative review

  • Mariam A. MalallahEmail author
  • Tariq F. Al-Shaiji
Review Article


Introduction and hypothesis

Treatment escalation from conservative directly to surgical in the management of pure stress urinary incontinence (SUI) reveals a gap for effective pharmacological treatments. The introduction of a drug therapy would fill this gap and widen the treatment options. Nevertheless, various pharmaceutical agents have been used off-label and are being investigated and becoming more widely available. In this review, we examined the latest published data regarding pharmacotherapy used in the treatment of SUI.


We performed a literature review to evaluate the relevant studies pertaining to any pharmacotherapy used in the management of SUI, examining the English language literature.


Currently, no drug exists that is approved by the food and drug administration for the management of SUI. A few oral pharmacological agents are occasionally used off-label. Lack of proven efficacy and high incidence of bothersome side effects of these agents limit their use. Duloxetine, a serotonin norepinephrine reuptake inhibitor, represents a major therapeutic advance for the treatment of SUI based on findings from a number of controlled clinical trials.


Several pharmacological agents have been used off-label and investigated for safety and efficacy, but none has demonstrated sufficient effectiveness to receive widespread verification for its use in the treatment of SUI.


Urinary incontinence Stress urinary incontinence Pharmacotherapy Duloxetine Serotonin norepinephrine reuptake inhibitor 





Estrogen replacement therapy


Food and Drug Administration


Incontinence episode frequency


Incontinence-specific Quality of Life questionnaire score


Medroxyprogesterone acetate




Patient Global Impression of Improvement


Pelvic floor muscle training




Quality of life


Randomized controlled trial


Serotonin norepinephrine reuptake inhibitors


Stress urinary Incontinence


Tricyclic antidepressants


Urgency urinary incontinence


World Health Organization/International Consultation on Incontinence


Conflicts of interest


Source of funding



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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  1. 1.Division of Urology, Department of SurgeryAl-Adan HospitalKuwaitKuwait
  2. 2.Division of Urology, Department of SurgeryAl-Amiri HospitalKuwaitKuwait

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