Medications

If you have already tried more conservative measures – like modifying your diet, bladder training and doing exercises to strengthen your pelvic floor – but these are not solving the problem, your health-care provider may recommend medication to treat your urinary incontinence.

There are several drugs available to help control the symptoms of incontinence. You and your health-care professional should discuss which drugs are best for you, how to take the drugs, and any possible adverse effects. Any drug may have contra-indications and should not be used in certain circumstances. Discuss these with your health-care professional before you start taking a drug.

Medications for Overactive Bladder

Medications to treat overactive bladder are aimed at relaxing the involuntary contractions of the bladder and improving bladder function. Medications commonly used to treat overactive bladder include:

• tolterodine tartrate (Detrol^®)
• oxybutynin chloride (Ditropan^®)
• solifenacin (Vesicare ®)
• darifenacin (Enablex ®)

You may experience some unwanted side effects when taking these medications. If you do, see your health-care professional before stopping the medication. Side effects include:

• dry mouth (most common)
• heartburn
• blurry vision
• nausea
• dizziness
• drowsiness
• increased heart rate
• difficulty urinating
• constipation
• impaired memory and confusion

Medications for Stress Incontinence

Medications to treat stress incontinence are aimed at increasing the muscle tone in the sphincter, which holds urine in the bladder. Strengthening these muscles with Kegel exercises is very effective, but not always enough.

Antidepressants, such as imipramine (Tofranil®), are sometimes used to treat the symptoms of stress incontinence although such a drug is not effective in most cases and its side effects can be serious.

The female hormone estrogen, which can affect the muscles and tissues in the pelvis, has also been used to treat urinary incontinence. Some early studies found that estrogen can increase the tone and blood supply of the urethral sphincter muscles; however, more recent studies have found no benefit in using estrogen therapy to prevent or treat urinary incontinence. The Women’s Health Initiative, a large long-term health study in the US, found that hormone therapy, with estrogen alone or a combination of estrogen and progestin, can worsen the symptoms of urinary incontinence.

Medications for Overflow Incontinence

For overflow incontinence, which is caused by a weak or underactive bladder muscle, cholinergic agents, such as bethanechol (Duvoid^®, Urecholine^®), may be prescribed.

Common side effects from cholinergic agents include:

• blurred vision
• dizziness
• nausea
• diarrhea