Medications for Stress Incontinence

Stress incontinence is the inability to control the flow of urine when stress is placed on the bladder. It is the most frequently occurring type of urinary incontinence experienced by women, according to the National Institutes of Health. Coughing, laughing, sneezing or physical exertion put pressure on the bladder; weakened pelvic muscles or urethral sphincter dysfunction allow urine to escape as a result. Causes include neurological problems, injury to the urethra and the use of certain medications. People at higher risk for stress incontinence include those who have given birth, experienced menopause, those who smoke or are obese and the elderly.

Treatment Protocol

• Treatment options for stress incontinence depend on the cause and the severity of symptoms. Medications are effective for people with mild to moderate symptoms. However, your physician may recommend lifestyle changes before deciding whether medication is necessary. Some of those changes include losing weight, giving up smoking, more frequent urination and reduced fluid intake. Exercises to strengthen the pelvic muscles also have proven effective. Several classes of drugs are available when indicated.

Antimuscarinic Drugs

• The first course of action when medication is indicated for the treatment of stress incontinence is the use of antimuscarinic drugs, according to the National Institutes of Health. These medications relax the muscles involved in bladder control and sometimes increase bladder capacity. Commonly prescribed antimuscarinics include tolterodine and oxybutynin.

Alpha-adrenergic Agonists

• Medications called alpha-adrenergic agonists activate receptors that respond to the hormone norepinephrine. This medication, which includes pseudoephedrine, phenylpropanolamine, ephedrine and epinephrine, has serious side effects on the cardiovascular system. Patients with high blood pressure, overactive thyroid, irregular heartbeat and heart pain must be monitored closely if alpha-adrenergic agonists are prescribed. Alpha-adrenergic agonists reduce symptoms by improving the strength of the sphincter.

Imipramine

• A tricyclic antidepressant called imipramine is sometimes used in the treatment of stress incontinence. Its effect is similar to that of the alpha-adrenergic agonist drugs, according to the National Institutes of Health.

Hormone replacement therapy

• In cases where stress incontinence is caused by changes in the urethral tissue following menopause, hormone replacement therapy may be used. HRT improves bladder control by improving the condition of the urethral tissue. Doctors are not in agreement about the efficacy of this treatment for symptoms of stress incontinence, according to the National Institutes of Health.

Collagen Injections

• If stress incontinence is caused by dysfunction in the urethral sphincter, recommended treatment may include injections of collagen into the periurethral area. Collagen injections help stop incontinence by thickening the tissue surrounding the urethra.