Urinary Incontinence Medications

Urinary incontinence is a medical condition in which a person loses control over the ability to pass urine. There are two types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence occurs during the course of particular activities such as exercising, laughing, sneezing, coughing, etc. This type of incontinence involves a bladder problem in which the urethral sphincter is not strong enough to control urination when abdominal activity increases pressure on the bladder. Stress incontinence may result from weak pelvic muscles that typically provide bladder support or from urethral sphincter malfunction. Urge incontinence manifests in a strong and sudden urge to urinate combined with an instant contraction of the bladder and involuntary urine loss. Urge incontinence can affect people of any age and gender, however, it is more common in women and the elderly. 

Urinary incontinence medications work to increase the strength of the urinary sphincter and pelvic muscles. Other medications also relax the bladder, thereby allowing it to contain more urine. Most urinary incontinence medications are most helpful for the treatment of urge incontinence although there are some that are effective for minimizing the effects of stress incontinence. Anticholinergics treat urinary incontinence by inhibiting involuntary bladder contractions, by increasing bladder capacity, and by delaying the initial urge to urinate. These medications include oxybutynin (Ditropan and Oxytrol), tolterodine (Detrol), hyoscyamine (Levbid and Cystopspaz), trospium (Sanctura), darifenacin (Enablex) solifenacin(Vesicare), and fesoterodine (Toviaz). Urinary incontinence medications such as these are capable of producing significant improvements, however, they are accompanied by the risk of certain side effects. The most common side effect of these drugs is dry mouth. Other possible anticholinergic side effects include dry eyes, headache, constipation, heartburn, and rapid heart rate. Those who wear contact lenses may especially suffer from drying of the eyes and are advised to begin treatment with low doses and gradually increase the amount over time. Older people who suffer from dementia or from degenerative mental diseases such as Alzheimer’s disease can experience forgetfulness, confusion, and a potentially accelerated rate of declining mental function. Hallucination is a possible side effect in children and older adults. 

Another common treatment is the estrogen hormone. Women’s bladders and urethras contain estrogen receptors. Estrogen is important in maintaining the flexibility and strength of tissues in these areas. Post-menopausal women produce less estrogen, which can result in incontinence problems. Estrogen-based urinary incontinence medications are available in topical forms such as vaginal creams, rings, or patches. These estrogen treatments can tone and revive the urethral areas and mitigate some of the symptoms of both stress and urge incontinence. Hormone replacement therapy and oral estrogen is no longer employed for the treatment of urinary continence because they function differently from topical estrogen and might actually worsen symptoms of incontinence. When topical estrogen is properly used, there are generally no side effects involved. However, estrogen treatments are usually combined with other urinary incontinence medications that may have side effects.

Imipramine (Tofranil) is another type of urinary incontinence medication. It is a tricyclic antidepressant that causes the bladder muscle to relax while making the smooth muscles at the neck of the bladder contract. This is an effective treatment for those suffering from a mixture of stress incontinence and urge incontinence. Imipramine can result in drowsiness, so it is commonly used at night time and for the treatment of children who suffering from chronic bed-wetting (nocturnal enuresis). Side effects of imipramine are rare but can include irregular heartbeat and dizziness upon standing up quickly. Older adult and children might be particularly susceptible to these side effects. Other possible side effects include dry mouth, blurry vision, and constipation.

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