Alpha-adrenoceptor blocking drugs and female urinary incontinence: prevalence and reversibility

There have been occasional reports of female stress incontinence related to prazosin therapy for hypertension. This drug is now rarely used but recently longer acting alpha-adrenoceptor blocking drugs have been introduced. We have, therefore, investigated the prevalence of urinary incontinence in all our female patients who were receiving alpha-adrenoceptor blockers in comparison with women, matched for age and parity who were receiving other drugs. We identified a total of 49 women taking alpha-adrenoceptor blocking drugs (prazosin 4, terazosin 5, doxazosin 40) among current patients who were attending our hypertension clinic. Twenty of these (40.8%) reported some urinary incontinence whereas in the control patients, only 8 (16.3%) had this symptom (P = < 0.02, relative risk 2.5, 95% CI 1.22-5.13). alpha-Adrenoceptor blockers were withdrawn in 18 of the 20 patients with incontinence and in 13, their symptoms abated. Our results suggest that there is a significantly higher prevalence of urinary incontinence in women taking alpha-adrenoceptor antagonists with reversibility on withdrawal of these drugs. As both female urinary incontinence, hypertension and the use of alpha-adrenoceptor blocking drugs are common, this distressing side effect should be borne in mind so that gynaecological or urological treatment may be avoided in some women.