Medication
There are several medications used to treat incontinence. The main types of incontinence that respond to drug treatment are stress and urge incontinence.
- Oestrogens are used to re-vitalise the urethral tissue structures enabling a better seal or closure.
- Alpha-adrenergic agonists. These drugs are used to contract the muscles around the bladder neck and urethra. This forms a tighter seal that keeps urine from leaking under pressure.
The medications used for urge incontinence or over-active bladder syndrome include:
- Anticholinergic agents: Anticholinergics reduce the number and strength of bladder contractions. This means these drugs are useful in managing frequency and urgency symptoms. These medicines have side effects that include dry mouth, constipation, blurred vision and palpitations. However, some anticholinergic are available as adhesive skin patches that have extended release properties and are said to have fewer adverse effects. Anticholinergic drugs ability to reduce bladder contractions has been well established and documented. The Cochrane Collaboration* has extensively studied anticholinergic therapy in randomised placebo-controlled trials. They found the effect of anticholinergics was greater than placebo (*Rai, Cody, Alhasso, & Stewart. 2012).
- Alpha-adrenergic antagonists: This drug is often used for men with an enlarged prostate to relax the smooth muscle of the urethra and allow a better flow of urine.
- Antidepressants: Some antidepressant are used to assist people who are disturbed by nocturia, waking up multiple times over-night to go to the toilet. Other antidepressants have both an anticholinergic and alpha-adrenergic agonist action and in low doses are used to manage overactive bladder.
All of these drugs should be used in conjunction with bladder training and pelvic floor exercises. The combination of these techniques provides the best option for managing the bladder spasms that cause urge incontinence and strengthening urethral resistance in stress incontinence. Each of these incontinence medications affects people differently. You should consult your doctor to determine the best treatment for you.
* International not-for-profit organisation preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care.
