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Intervention Review

Adrenergic drugs for urinary incontinence in adults

  1. A Alhasso Specialist Registrar in Urology*,
  2. CMA Glazener,
  3. R Pickard,
  4. J N'Dow

Editorial Group: Cochrane Incontinence Group

Published Online: 22 APR 2003

DOI: 10.1002/14651858.CD001842

How to Cite

Alhasso A, Glazener CMA, Pickard R, N'Dow J. Adrenergic drugs for urinary incontinence in adults. The Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD001842. DOI: 10.1002/14651858.CD001842.

Author Information

  1. Department of Urology, Edinburgh, UK

*A Alhasso, Specialist Registrar in Urology, Department of Urology, Western General Hospital, Edinburgh, EH4 2XU, UK.

Publication History

  1. Published Online: 22 APR 2003


This is not the most recent version of the article. View current version (20 JUL 2005)



  1. Top of page
  2. Abstract
  3. Synopsis


Adrenergic drugs have been used for the treatment of urinary incontinence. However, they have generally been considered to be ineffective or to have side effects which may limit their clinical use.


To determine the effectiveness of adrenergic agonists in the treatment of urinary incontinence in adults.

Search strategy

We searched the Cochrane Incontinence Group trials register (January 2002) and the reference lists of relevant articles. Date of the most recent searches: January 2002.

Selection criteria

Randomised or quasi-randomised controlled trials which include an adrenergic agonist drug in at least one arm for adults with urinary incontinence.

Data collection and analysis

Two reviewers independently assessed eligibility, trial quality and extracted data. Data were processed as described in the Cochrane Collaboration Handbook.

Main results

Fifteen randomised trials were identified, which included 832 women, of whom 506 received an adrenergic drug (phenylpropanolamine in 11 trials, Midodrine in two and Clenbuterol in another two). Of these, six were crossover trials. No trials included men.

The limited evidence suggested that an adrenergic agonist drug is better than placebo in reducing number of pad changes and incontinence episodes, as well as improvement in subjective symptoms. The drugs also appeared to be better than pelvic floor muscle training in two small trials, possibly reflecting relative acceptability of the treatments to women but perhaps due to differential withdrawal of women from the trial groups. There was not enough evidence to evaluate the use of higher compared to lower doses of adrenergic agonists nor the relative merits of an adrenergic agonist drug compared with oestrogen, whether used alone or in combination.

Authors' conclusions

There was weak evidence to suggest that use of an adrenergic agonist is better than placebo treatment. There was not enough evidence to assess the effects of adrenergic agonists when compared to or combined with other treatments. Patients using adrenergic agonists may suffer from minor side effects, only occasionally leading them to stop treatment. Rare but serious side effects such as cardiac arrhythmias and hypertension have been reported, however.



  1. Top of page
  2. Abstract
  3. Synopsis


The review found some weak evidence that adrenergic agonist drugs effectively treat stress urinary incontinence in women, although with some adverse effects.

Urinary incontinence is the leakage of urine, and when caused by coughing or exercising it is called stress incontinence. It may be caused by damage to muscles holding up the bladder or holding the bladder neck closed. Adrenergic agonist drugs may help by contracting the bladder neck muscle. This review found weak evidence that adrenergic agonists may help stress urinary incontinence. Side effects are usually minor. Rarely, more serious adverse effects such as high blood pressure occur.