Urge incontinence

• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z

Female urinary tract

Male urinary tract

Overactive bladder; Detrusor instability; Detrusor hyperreflexia; Irritable bladder; Spasmodic bladder; Unstable bladder; Incontinence - urge

There are several different approaches that may be used in managing and treating urge incontinence. If evidence of infection is found in urine culture, antibiotics will be prescribed. The choice of a specific treatment will depend on the severity of the symptoms and the extent that the symptoms interfere with lifestyle. There are three main approaches to treatment: medication, retraining, and surgery.

MEDICATION

Medications used to treat urge incontinence are aimed at relaxing the involuntary contraction of the bladder and improving bladder function. There are several types of medications that may be used alone or in combination:

• Anticholinergic agents (oxybutynin, tolterodine, enablex, sanctura, vesicare, oxytrol)
• Antispasmodic medications (flavoxate)
• Tricyclic antidepressants (imipramine, doxepin)

Oxybutynin (Ditropan) and tolterodine (Detrol) are medications to relax the smooth muscle of the bladder. These are the most commonly used medications for urge incontinence and are available in a once-a-day formulation that makes dosing easy and effective.

The most common side effects of anticholinergic medicines are dry mouth and constipation. The medications cannot be used by patients with narrow angle glaucoma.

An antispasmodic drug is flavoxate (Urispas). However, studies have shown inconsistent benefit in controlling symptoms of urge incontinence.

Tricyclic antidepressants have also been used to treat urge incontinence because of their ability to inhibit or "paralyze" the bladder smooth muscle. Possible side effects include fatigue, dry mouth, dizziness, blurred vision, nausea, and insomnia.

SURGERY

The goal of any surgery to treat urge incontinence is aimed at increasing the storage ability of the bladder while decreasing the pressure within the bladder. Surgery is reserved for patients who are severely debilitated by their incontinence and who have an unstable bladder (severe inappropriate contraction) and poor ability to store urine.