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Medication Used for Urge Incontinence

Urge incontinence is an involuntary leakage of urine that has a variety of causes and surfaces as a sudden need to urinate. Urge incontinence can occur in anyone, but it is more common in women and the elderly.

  1. Symptoms

    • Symptoms include abdominal discomfort, frequent and sudden urination, and involuntary loss of urine. Retention of urine can cause abdominal distension (stomach swelling).

    Causes

    • Most cases of urge incontinence have no specific cause, though it can result from serious conditions such as bladder cancer, stones and inflammation; an obstruction or infection; or neurological diseases or injuries. In men, it may be caused by benign prostatic hypertrophy, which is obstruction from an enlarged prostate gland.

    Process

    • The nervous system signals the need to urinate after the bladder stretches while it is holding urine. When the bladder empties, muscles contract to squeeze the urine out. The sphincter muscle relaxes so that urine can flow.

    Bladder Muscle Relaxants

    • Medications for urge incontinence relax the bladder and stop spasms. Anticholinergic (smooth muscle relaxer) medications include oxybutynin, tolterodine, darifenacin, trospium, solifenacin and flavoxate. Tricyclic antidepressants such as imipramine and doxepin also treat urge incontinence by relaxing smooth bladder muscles.

    Alpha-Blocker Treatments

    • Alpha-blockers, also used to treat heart conditions, relax bladder muscles and cause blood vessels to stay open. These are prescribed for treatment of benign prostatic hypertrophy and consist of doxazosin mesylate, tamsulosin hydrochloride and terazosin hydrochloride.

    Non-Pharmaceutical Treatment

    • The patient keeps a diary or chart of all episodes of urination to identify patterns to help the doctor plan a bladder training program. Feedback and exercises help the patient retrain the bladder to postpone urination, strengthen the pelvic floor muscles and urinate according to a schedule. Surgery is reserved for patients with severe conditions of urge incontinence. In augmentation cystoplasty, a segment of the bowel is attached to the bladder to increase its size and enable it to store more urine.

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