Effect of methoxamine on maximum urethral pressure in women with genuine stress incontinence: A placebo-controlled, double-blind crossover study

The aim of the study was to evaluate the potential role for a selective alp ha (1)-adrenoceptor agonist in the treatment of urinary stress incontinence . A randomised, double-blind, placebo-controlled. crossover study design wa s employed. Half log incremental doses of intravenous methoxamine or placeb o (saline) were administered to a group of women with genuine stress incont inence while measuring maximum urethral pressure (MUP), blood pressure, hea rt rate, and symptomatic side effects. Methoxamine evoked non-significant i ncreases in MUP and diastolic blood pressure but caused a significant rise in systolic blood pressure and significant fall in heart rate at maximum do sage. Systemic side effects including piloerection, headache, and cold extr emities were experienced in all subjects. The results indicate that the cli nical usefulness of direct, peripherally acting sub-type-selective alpha (1 )-adrenoceptor agonists in the medical treatment of stress incontinence may he limited by associated piloerection and cardiovascular side effects. Neu rourol. Urodynam. 20:43-52. 2001. (C) 2001 Wiley-Liss. Inc.