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 alpha (1)-adrenoceptor agonist in the treatment of urinary stress incontinence. A randomised, double-blind, placebo-controlled. crossover study design was employed. Half log incremental doses of intravenous methoxamine or placebo (saline) were administered to a group of women with genuine stress incontinence while measuring maximum urethral pressure (MUP), blood pressure, heart rate, and symptomatic side effects. Methoxamine evoked non-significant increases in MUP and diastolic blood pressure but caused a significant rise in systolic blood pressure and significant fall in heart rate at maximum dosage. Systemic side effects including piloerection, headache, and cold extremities were experienced in all subjects. The results indicate that the clinical 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. Neurourol. Urodynam. 20:43-52. 2001. (C) 2001 Wiley-Liss. Inc.