Initial clinical experience with the selective phosphodiesterase-1 isoenzyme inhibitor vinpocetine in the treatment of urge incontinence and low compliance bladder

Current pharmacological treatment modalities for urge incontinence and low compliance bladder are limited by a low clinical efficacy and the significa nt side effects of the standard drugs available. Previous in vitro studies indicated a possible functional relevance of the intracellular phosphodiest erase (PDE)-1 isoenzyme in the regulation of human detrusor smooth muscle c ontractility. We therefore investigated the effect of the PDE-1 inhibitor v inpocetine in nonresponders to standard pharmacological therapy. In 11/19 p atients (57.9%) clinical symptoms and/or urodynamic parameters were improve d. Although these initial data are preliminary, they represent the first ev idence that isoenzyme-selective PDE inhibition may be a novel approach to t he treatment of lower urinary tract disorders.