Effects of Pseudoephedrine on Urinary and Voiding Function in Adults: A Systematic Review

Abstract

Introduction: Pseudoephedrine is a sympathomimetic decongestant that may affect urinary function by increasing bladder outlet resistance. Objective: To synthesize clinical evidence on the effects of pseudoephedrine on urinary and voiding function in adults. Method: This systematic review was prospectively registered in PROSPERO (CRD420261485354). PubMed, Scopus, and ScienceDirect were searched on 19 August 2026. Eligible studies were original human studies of adults receiving systemic pseudoephedrine and reporting urinary or voiding outcomes. Findings were synthesized narratively because of clinical and methodological heterogeneity. Result and Discussion: Three prospective studies involving 387 participants were included. Overall, pseudoephedrine produced minimal changes in urinary function. In men, urinary symptom scores generally increased without significant overall deterioration. Men aged 50 years or older showed significant increases in total symptom scores, while higher baseline symptom severity was associated with greater deterioration and increased residual urine volume. In premenopausal women without urinary symptoms, short-term use did not significantly impair urodynamic or urethral neuromuscular parameters. Conclusions: Pseudoephedrine appears to have limited urinary effects in most adults, but older men and individuals with greater baseline urinary symptoms may require greater caution. Further studies are warranted