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Traitement médical de l’incontinence urinaire

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Pelvi-périnéologie

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Résumé

Le traitement médical est dominé par la connaissance des mécanismes pharmacologiques mettant en jeu le bas appareil urinaire et tout particulièrement la transmission adrénergétique et cholinergétique. L’instabilité vésicale doit être traitée par des anticholinergiques. Ce sont les seuls qui ont une AMM spécifique. Ils stoppent les récepteurs périphériques du système parasympathique et assurent aussi le relâchement du detrusor. Ces médicaments antispasmodiques agissent sur les spasmes des muscles lisses et suppriment aussi les contractions au niveau des muscles lisses et des sphincters. Les antidépresseurs tricycliques de première génération possèdent une activité anticholinergique pouvant être utilisée. L’instabilité sphinctérienne doit être traitée par des médicaments alpha-mimétiques qui provoquent la fermeture du col et de l’urètre. Les œstrogènes (estradiol mais aussi local estriol) sont intéressants. Ils jouent un rôle important dans le mécanisme de la continence.

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  1. Faculté de pharmacie, Hôpital de La Timone, 27, boulevard Jean-Moulin, 13005, Marseille

    A. Durand

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  1. A. Durand
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Durand, A. (2005). Traitement médical de l’incontinence urinaire. In: Pelvi-périnéologie. Springer, Paris. https://doi.org/10.1007/2-287-27807-9_10

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  • DOI: https://doi.org/10.1007/2-287-27807-9_10

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-00501-5

  • Online ISBN: 978-2-287-27807-5

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