dinoprost and Urinary-Incontinence--Stress

Sixty-nine women with a clinically and urodynamically proven diagnosis of genuine stress incontinence underwent urethropexy in the form of the revised Pereyra procedure (n = 28) or Burch colposuspension (n = 41). Postoperatively the patients were assigned randomly to one of three study groups. Group 1 received a daily saline injection to the bladder (control group, n = 24), group 2 received daily intravesical injections of 250 mg of prostaglandin F2 alpha (PGF2 alpha) (n =23), and group 3 received a daily 10-mg PGE2 (PGE2) vaginal suppository (n = 22). The patients' suprapubic catheter was removed once the postvoiding residual urine volume was less than or equal to 50 mL. Both PGE2 and PGF2 significantly reduced the length of time required for postoperative bladder drainage after both the Burch and Pereyra procedures as compared to that in the control group (P less than .05). Hospital stay and bacteriuria were reduced as well in women receiving postoperative prostaglandins as compared to the control group. Clinically there were no differences between PGE2 and PGF2 alpha. Both produced no side effects, were well tolerated by the patients and were effective in reducing both the number of days required for bladder catheterization and the incidence of significant bacteriuria when administered after the surgical procedures.

Topics: Adult; Aged; Dinoprost; Dinoprostone; Female; Humans; Middle Aged; Postoperative Care; Prospective Studies; Random Allocation; Urinary Bladder; Urinary Incontinence, Stress

Prostaglandin F2 alpha 10 mg was administered intravesically in a double-blind placebo-controlled study to promote micturition in cases of urinary retention after operative treatment of urinary stress incontinence in women. Fifteen of 18 patients (83%) succeeded in voiding after treatment with prostaglandin F2 alpha, but the placebo was ineffective in all 18 patients (P less than 0.001). Although the effect of prostaglandin F2 alpha on bladder muscle contraction was short-lived, it seemed to enhance the restoration of bladder motor function with no serious side effects, and thus to be clinically useful in the treatment of post-operative urinary retention.

Topics: Administration, Intravesical; Adult; Aged; Clinical Trials as Topic; Dinoprost; Double-Blind Method; Female; Humans; Middle Aged; Postoperative Complications; Prostaglandins F; Random Allocation; Urinary Incontinence, Stress; Urination Disorders

Topics: Administration, Intravesical; Adult; Aged; Dinoprost; Double-Blind Method; Female; Humans; Middle Aged; Placebos; Postoperative Care; Random Allocation; Urinary Bladder; Urinary Incontinence, Stress; Urination

The topography of prostaglandin (PG) E and F2 alpha receptors in uteri of premenopausal women was investigated by dividing uteri into six equal longitudinal strips and further dividing each strip into approximately 1-cm segments. Tissue for determination of smooth muscle content using the Trichrome stain was taken from each section, and the remainder was homogenized for binding studies with 3H-labeled PGs. The [3H] PGE1 binding (mean, 41.5 fmol/mg protein; range, 23.1-58.3) was about 8-fold greater in the fundus than [3H]PGF2 alpha binding (mean, 4.8 fmol/mg protein; range, 1.3-13.0), and this trend was found in most uterine sections. The binding of both 3H-labeled PGs decreased from fundus to cervix, and this decrease was similar to the decrease in smooth muscle content. Scatchard analysis revealed apparent dissociation constants (Kds) of 1.4 and 76 nM and apparent specific binding capacities (Ns) of 25 and 488 fmol/mg protein for [3H]PGE2, and Kd values of 11.5 and 81 nM and Ns values of 19.4 and 58 fmol/mg protein for [3H]PGF2 alpha in the uterine fundus. The Kd values for [3H]PGE2 were similar in other sections of the uterus, but the Ns values were smaller in the lower uterine body and cervical end. While the phase of the menstrual cycle did not influence [3H]PG binding, the diagnosis of abnormal uterine bleeding compared to dysmenorrhea was associated with an increase in [3H]PGE1 binding (P less than 0.05).

Topics: Adult; Dinoprost; Dysmenorrhea; Female; Genital Diseases, Female; Humans; Menstruation; Middle Aged; Muscle, Smooth; Prostaglandins E; Prostaglandins F; Receptors, Cell Surface; Receptors, Prostaglandin; Receptors, Prostaglandin E; Tissue Distribution; Urinary Incontinence, Stress; Uterine Hemorrhage; Uterus