Twenty-nine postmenopausal women with slight to severe
stress urinary incontinence and
estrogen deficiency symptoms in the urogenital tract were treated with
estriol, p.o. 4 mg once daily, and either
phenylpropanolamine (PPA), p.o. 50 mg twice daily, or placebo for periods of 6 weeks according to a randomized double-blind crossover schedule. At urodynamic recordings the maximum urethral closure pressure increased by 22% with combined treatment (p less than 0.001) and an additional effect of PPA to
estriol was shown (p = 0.022). The pressure transmission ratio increased, by about 15%, with both treatments (p less than 0.07). The number of leakage episodes was reduced by 28% with combined treatment (p = 0.007), but not with
estriol alone (p = 0.08). Both combined treatment and
estriol alone reduced significantly (p less than 0.01) the
urinary incontinence complaints. Twelve women (43%) preferred combined treatment, while 7 (25%) preferred
estriol alone. In women with initially slight to very severe urine loss, combined treatment reduced also (p = 0.02) the amount of urine loss, measured at a standardized physical stress test. Signs of
estrogen deficiency in vulva, vagina and urethra were reduced, 75% (p less than 0.001) or 65% (p = 0.001) with
estriol given in combination with PPA or alone. Maturation index of both urethral and vaginal epithelium displayed significant changes. It is concluded that the combined treatment, PPA +
estriol, by affecting both the muscular and mucosal factor of the urethra, is more effective than
estriol alone for treatment of female
stress urinary incontinence in the postmenopausal ages.