 Urinary incontinence is the uncontrollable loss of urine from the bladder. First, your doctor will perform an evaluation to determine the cause of the incontinence. Exercises, prescription medicines, and surgery are the usual treatments for this condition. Doctors choose a particular therapy based on cause and the type of incontinence. Sometimes, bladder infections can cause sudden but temporary loss of bladder control. If you have a bladder infection, your doctor may prescribe antibiotics. Loss of bladder control for several weeks or longer can have various causes. Doctors separate this type of incontinence into three main types – urge, overflow, and stress. Oxybutynin (brand name Ditropan) hyoscyamine (Levsin), and tolterodine (>Detrol) can help people with urge incontinence. These medicines can reduce bladder muscle spasms and improve urine control. A common side effect of these medicines is dry mouth. Long-acting forms of these medicines may be helpful in decreasing the amount of side effects. Pseudoephedrine (>Sudafed) may improve muscle control in people with stress incontinence, although this drug is no longer available over-the-counter, only behind-the-counter due to new restrictions. For women who have reached menopause, the doctor may consider estrogen replacement (>Premarin, >Menest) to improve pelvic muscle strength. Imipramine (>Tofranil), an antidepressant, has been helpful in urge or stress incontinence. It increases bladder volume and improves control of urine flow. For overflow incontinence caused by an enlarged prostate, tamsulosin (>Flomax) or terazosin (>Hytrin) may help to improve urinary flow.
In some cases, hormone replacement may help women who need more estrogen. The best forms to use include vaginal cream, ring or patch. Sources:
Applied Therapeutics: The Clinical Use of Drugs. Applied Therapeutics, 1995.
Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Harrison’s Principles of Internal Medicine. McGraw-Hill Companies, 1998.
Mayo Clinic Family Health Book. William Morrow & Co., 1996.
Swartzberg JE, S Margen. The UC Berkeley Wellness Self-Care Handbook. Rebus Inc., 1998.
Urinary Incontinence in Adults: Acute and Chronic Management. Agency for Health Care Policy and Research, 1996.
Diseases and Conditions. “Urinary incontinence”. www.mayoclinic.com. Mayo Clinic Health. Last accessed 12/2006.
This answer prepared 11/6/2000.
This information updated 2/6/2007.
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