Conservative treatment of urinary incontinence in women with special reference to the use of oestrogens.

Urinary incontinence was treated conservatively in 100 patients. The follow-up period was 12-24 mth. For post-menopausal women, the oestrogen therapy consisted of oral oestradiol valerate or vaginal oestrone sulphate combined with emepronium bromide. In post-menopausal patients the best results were noted when incontinence had begun at the menopause and when the duration of the complaint was not more than 3 yr. For pre-menopausal patients, the treatment given was generally emepronium bromide. During the follow-up period 15 of the patients, 11 of whom were post-menopausal, became symptomless and 77 improved; that is, the incontinence was only slight and occasional. The treatment was without any effect in 8 of the patients. Oestrogen therapy was successful in most post-menopausal women. In these patients, the best results were obtained when the duration of the incontinence was not more than 3 yr.

[Urological complications in patients with multiple sclerosis (author's transl)]. / Urologische Komplikationen bei neurologischen Erlankungen.

63 patients with multiple sclerosis underwent urodynamic evaluation. Hyperreflexia of the bladder was found in 64% and areflexia in 8%. Hypertrophy or sclerosis of the bladder neck (internal sphincter) was detected in 27% of the patients and a spastic external sphincter (dyssynergia) was encountered in 57%. 16 patients were admitted for surgery: 9 for TUR of the bladder neck, 5 for percutaneous selective sacral nerve block, 2 for ileal diversion, 2 for prolonged bladder distension and 1 for nephrectomy for staghorn calculi of the renal pelvis. Highly effective conservative therapy is available in the form of Lioresal for treatment of the hyperactive detrusor muscle and Dibenzyran - an alpha-adrenergic blocking agent - to relieve bladder neck spasticity.

Iatrogenic reflux oesophagitis.

A report on two patients with severe reflux oesophagitis caused by Emepronium Bromide ('CETIRPIN') prescribed for the treatment of urinary symptoms.

The effect of intravesically administered Cetiprin on bladder spasms after transurethral resection of the prostate. A double-blind randomized study.

A double-blind study of the short-term effects of intravesically administered emepronium bromide (Cetiprin) versus placebo on bladder spasms after transurethral prostatectomy was done in 40 male patients. In the Cetiprin group there was a significant decline in the need for analgesia, and significantly fewer catheter problems. The use of intravesically instilled Cetiprin is recommended only in cases of severe postoperative bladder spasms.

The effect of parenteral emepronium bromide (Cetiprin) on postoperative vesical tenesms after transurethral resection of the prostate. A randomized, placebo-controlled study.

Sixty patients were randomized to treatment with either emepronium bromide (Cetiprin) 25 mg t.i.d. or placebo, both medications administered intramuscularly, after transurethral resection of the prostate. Postoperatively, the number of episodes with vesical tenesms and the need for adjuvant analgesic medication were registered. No significant differences in the number of episodes with vesical tenesms or the need for adjuvant analgesic medication were found between the patients treated with emepronium bromide and those treated with placebo.

A symptomatic and cystometric comparison of terodiline with emepronium in the treatment of women with frequency, urgency and incontinence.

Terodiline has been compared with emepronium in the treatment of 20 women suffering with frequency, urgency and incontinence in a double-blind, two-way cross-over study with fixed placebo as wash-out. A significant number of patients preferred terodiline treatment and a closer correlation between symptomatic and cystometric improvement has been seen during treatment with this drug. Regression analyses indicate that patients with high micturition frequencies (12 to 15 per 24 hours) benefit more from treatment than those with lower frequencies do.

Oesophageal stricture associated with emepronium bromide therapy.

Emepronium bromide, a drug used to control urinary frequency, has been reported as causing oesophageal ulceration but not stricture formation. This paper presents 3 cases in which the use of emepronium bromide preceded development of an oesophageal stricture and suggests that the drug played a causative role.

Urinary incontinence in old age. A controlled clinical trial of emepronium bromide.

The effect of the anticholinergic agent, emepronium bromide (Cetiprin), was studied in a double blind crossover study of a group of elderly patients with urinary incontinence and uninhibited bladder contractions during cystometry. There was no statistically significant difference between the subjective effect of emepronium bromide and that of placebo, and no change in the cystometric parameters. The overall subjective cure or improvement rate was 79%. The effect of anticholinergic drugs in the treatment of urinary incontinence in elderly patients with uninhibited bladder contractions might to some extent be due to an improvement in the patients' understanding and acceptance of the bladder disorders.

The lack of effect of intramuscular emepronium bromide for urinary incontinence.

Six elderly volunteers (4 men and 2 women), suffering from urinary incontinence due to small capacity, hyper-reflexic bladders, were assessed cystometrically 1/2 h, 1 h and 4 h after an intramuscular injection of emepronium bromide (Cetiprin). The dose given was sufficient to raise serum levels of emepronium to approximately 10 times those that could be reached with an oral dose. Analysis of the results showed that there was no significant difference in the state of the bladder at any time. The study confirms that emepronium bromide is ineffective in increasing bladder capacity in subjects with small, hyper-reflexic bladders. It has no value, therefore, in the management of urinary incontinence in elderly patients with this condition.