Medications For Urinary Incontinence
Other names: Bladder, Weak Incontinence Incontinence, Urge Urge Incontinence Weak Bladder
Incontinence is the inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine.
The three main types of urinary incontinence are:
Stress incontinence — occurs during certain activities like coughing, sneezing, laughing, or exercise.
Stress incontinence is a bladder storage problem in which the strength of the muscles that help control urination is reduced. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen.
Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra or because of a malfunction of the urethral sphincter.
Treatment for stress incontinence may include behavioral changes, medication, pelvic floor muscle training or surgery.
Urge incontinence — involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. You don’t have enough time between when you recognize the need to urinate and when you actually do urinate.
In most cases of urge incontinence, no specific cause can be identified.Although urge incontinence may occur in anyone at any age, it is more common in women and the elderly.
Treatment for urge incontinence may include medication, retraining, and surgery.
Mixed incontinence — contains components of both stress and urge incontinence.
Botox Injection For Bladder Problems
Botox injection has recently been approved by the Food and Drug Administration for the treatment of overactive bladder for patients who have failed to respond to standard therapy with anticholinergic medications.
Overactive bladder is a type of urinary incontinence caused by overactivity of the muscles in the bladder, causing frequent squeezing of the bladder and, thus, frequent urge to urinate. Botox can be injected into the bladder directly through a cystoscope .
Lifestyle And Home Remedies
Problems with urine leakage may require you to take extra care to prevent skin irritation:
- Use a washcloth to clean yourself.
- Allow your skin to air-dry.
- Avoid frequent washing and douching because these can overwhelm your body’s natural defenses against bladder infections.
- Consider using a barrier cream, such as petroleum jelly or cocoa butter, to protect your skin from urine.
- Ask your doctor about special cleansers made to remove urine that may be less drying than other products.
If you have urge incontinence or nighttime incontinence, make the toilet more convenient:
- Move any rugs or furniture you might trip over or collide with on the way to the toilet.
- Use a night light to illuminate your path and reduce your risk of falling.
If you have functional incontinence, you might:
- Keep a bedside commode in your bedroom
- Install an elevated toilet seat
- Widen an existing bathroom doorway
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Antidepressants And Narcotic Pain Relievers
Some antidepressants and pain medications can prevent the bladder from contracting completely so that it does not empty. That gives rise to issues with urgency or frequency. They can also decrease your awareness that you need to go to the bathroom.
Some of these drugs can also cause constipation, Dr. Rackley says. Constipation, in turn, can cause indirect bladder incontinence, because being constipated takes up more room in the pelvis that the bladder needs to expand.
What You Can Do
To get ready for your appointment, it helps to:
- Be aware of any pre-appointment restrictions, such as restricting your diet
- Write down your symptoms, including how often you urinate, nighttime bladder activity and episodes of incontinence
- Make a list of all your medications, vitamins and supplements, including doses and how often you take the medication
- Write down key medical information, including other conditions you may have
- Ask a relative or friend to accompany you, to help you remember what the doctor says
- Take a notebook or electronic device with you, and use it to note important information during your visit
- Write down questions to ask your doctor
For urinary incontinence, some basic questions to ask your doctor include:
- What’s the most likely cause of my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is my urinary incontinence temporary?
- What treatments are available?
- Should I anticipate any side effects of the treatment?
- Is there a generic alternative to the medicine you’re prescribing for me?
- I have other health conditions. How can I best manage these conditions together?
Don’t hesitate to ask other questions during your appointment as they occur to you.
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Urinary Incontinence Due To Medications
Aka: Urinary Incontinence due to Medications, Medication Causes of Urinary Incontinence, Drug-Induced Urinary Incontinence
III. Causes: Analgesic
IV. Causes: Neuropsychiatric
V. Causes: Miscellaneous
Medications That May Cause Increased Urination
There are several potential causes of frequent urination, and the meds youre taking might be one of them.
Maybe youve noticed that youre rushing to the restroom lately. Or youre waking up in the middle of the night to go. Perhaps you’re needing to take way more breaks at work to pee.
There are many potential causes of frequent urination. They include, but are not limited to, an increase in water intake, a urinary tract infection, or onset of a new disease such as diabetes, as the Mayo Clinic notes.
Its worth asking yourself: Have I started a new medication lately?
That gotta-go impulse is a relatively common side effect of various drugs available over-the-counter and by prescription. Many medications can lead to urinary retention and something we call overflow incontinence, which is when the bladder is not able to contract and expel urine effectively, leaving urine in the bladder, says Brooke D. Hudspeth, PharmD, an associate professor and the chief practice officer at the University of Kentucky College of Pharmacy in Lexington. Other meds may interfere with the function of the urethra and lead to leakage or cause the bladder to quickly fill up with urine and make you pee more frequently.
Whether youre on diuretics to reduce your blood pressure, a decongestant to clear your sinuses, or a mood-stabilizing medication for bipolar disorder, here are some common medications that may be causing you to urinate more.
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Antidepressants As A Cause Of Urinary Incontinence
Antidepressants can impair the contractility of the bladder, and that can worsen symptoms of overflow incontinence, in which the bladder can’t empty completely. Other antidepressants may decrease your awareness of the need to void.
If you think your antidepressant is worsening your incontinence, talk to your doctor about switching to another medication.
Home Remedies For Urinary Incontinence
Urinary incontinence can be described as the inability to control urination, leading to urine leakage or involuntary loss of urine.
It is a very common, and at times debilitating, urological disorder. According to the National Association for Continence , it affects about 25 million Americans.
Urinary incontinence can be divided into three main types:
- Urge incontinence occurs when an overactive or hyperactive bladder causes a sudden and intense urge to urinate causing involuntary loss of urine
- Stress incontinence occurs when physical activities like vigorous exercise, jumping, coughing, sneezing or even laughing put pressure on the bladder and it releases urine
- Overflow incontinence inability to completely empty the bladder, leading to frequent or constant dribbling of urine
Incontinence can be caused by a number of factors like age , weakened pelvic floor muscles due to surgery or childbirth, enlarged prostate, menopause, an overactive bladder, nerve damage, urinary stones, urinary tract infections and constipation.
Plus, certain foods, drinks and medications may stimulate your bladder and cause temporary incontinence.
It not only can cause discomfort and embarrassment, but can also be harmful if urine is left in the bladder creating a breeding ground for bacteria. Incontinence is not a disease in itself, but a symptom of an underlying condition or disorder.
Here are the top 10 home remedies for urinary incontinence.
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What Is Urinary Incontinence
Urinary incontinence is a loss of control over urination. Urine leaks before you are able to get to a toilet.
Normally, kidneys make urine that travels through tubes into the bladder. The bladder is a balloon-shaped structure with walls of muscle. The muscular walls are relaxed until the bladder fills up. The underside of the bladder is supported by pelvic floor muscles.
When the bladder is full, the walls of the bladder are stretched. That signals the muscular walls to squeeze down, causing an urge to urinate. When you are ready to urinate, the muscular walls squeeze down harder, and another tube opens up that carries urine out of the bladder and into the outside world.
With the various types of urinary incontinence, this normal process gets disrupted.
One type of incontinence is stress incontinence. Your pelvic muscles are located beneath your bladder. Stress incontinence occurs when your pelvic muscles aren’t strong enough. They cannot withstand a “stress” or pressure pushing on the bladder.
When your pelvic muscles give way, they release their squeeze around the bottom of your bladder. As a result, urine can drain out.
Stress incontinence is common during:
- Some awkward body movements
Many women have urinary incontinence after childbirth. Pregnancy and childbirth can affect the conditioning of the pelvic muscles. They can also stretch and injure the pelvic nerves. Incontinence may last for a surprisingly long time after childbirth.
How Well Do Medicines For Urinary Urgency And Incontinence Work
For duloxetine, one study showed that in about 6 in 10 women who took duloxetine, the number of urine leakages halved compared to the time before they took the medication. Therefore, on its own, duloxetine is not likely to cure the incontinence but may help to make it less of a problem. However, duloxetine in addition to pelvic floor exercises may give a better chance of curing the incontinence than either treatment alone.
Antimuscarinic medicines are all thought to be as effective as each other. They may improve symptoms in some cases but not in all. The level of improvement varies from person to person. You may have fewer toilet trips, fewer urine leaks and less urgency. However, it is uncommon for symptoms to go completely with medication alone.
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Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.
The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.
The reason your detrusor muscles contract too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity
Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.
Your detrusor muscles may not fully contract if:
- there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
- you’re taking certain medicines
Medicine For Stress Incontinence
If stress incontinence does not significantly improve with lifestyle changes or exercises, surgery will usually be recommended as the next step.
However, if you’re unsuitable for surgery or want to avoid an operation, you may benefit from an antidepressant medicine called duloxetine. This can help increase the muscle tone of the urethra, to help keep it closed.
You’ll need to take duloxetine tablets twice a day and will be assessed after 2 to 4 weeks to see if the medicine is beneficial or causing any side effects.
Possible side effects of duloxetine can include:
Do not suddenly stop taking duloxetine, as this can also cause unpleasant side effects. A GP will reduce your dose gradually.
Duloxetine is not suitable for everyone, however, so a GP will discuss any other medical conditions you have to determine if you can take it.
Beta Agonists For Bladder Problems
This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.
- How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
- Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
- Allergy to this drug
- Advanced kidney disease
Pelvic Floor Muscle Exercises
Your doctor may recommend that you do these exercises frequently to strengthen the muscles that help control urination. Also known as Kegel exercises, these techniques are especially effective for stress incontinence but may also help urge incontinence.
To do pelvic floor muscle exercises, imagine that you’re trying to stop your urine flow. Then:
- Tighten the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
To help you identify and contract the right muscles, your doctor may suggest that you work with a pelvic floor physical therapist or try biofeedback techniques.
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Three Types Of Incontinence
In order to discuss medication-induced incontinence, its important to first understand the three basic types of incontinence. They are:
- Stress. This is when urine leaks due to increased abdominal pressure, often brought on by laughing, coughing, sneezing or other physical activity. Stress incontinence occurs mostly in women.
- Urge. The urge to urinate comes on suddenly and strongly, and urine leaks if a bathroom isnt immediately available. This affects both men and women.
- Overflow. This mainly affects men. Its caused by an inability to expel urine, resulting in bladder overflow and urine leakage.
Oab Or Incontinence Medications Used In Canada
|The most common adverse events found with anticholinergic medications include : dry mouth, constipation, impaired cognition and blurred vision. Talk to your doctor about limiting these side effects and which medication may be right for you.|
The two most commonly prescribed anticholinergic drugs are oxy- butynin and tolterodine , both of which are available in extended-release formulations.
Recently, medications have been developed that also limit unwanted side effects. These medications include darifenacin , solifenacin , trospium , fesotoredine , Myrbetriq® and oxybutynin chloride gel . Gelnique, is rubbed into the skin, making side effects like dry mouth milder because of constant absorption rates. Myrbetig is a new drug that works by a different mechanism to relax the bladder muscle without blocking the action of acetyl choline and therefore produces lesser side effects. The other drugs are anti-cholinergics but are more specific to the bladder muscle.
Re-injection can be considered when the effect diminishes but not within three months of the last injection
Since estrogen helps keep the urethra healthy and strong, the drop in estrogen that occurs in women after menopause especially with aging may contribute to incontinence. Applying estrogen in the form of a vaginal cream , tablet or ring may help ease symptoms of both stress and urge incontinence.
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Medications That Cause Incontinence
There are seven classes of commonly prescribed medication that are associated with urinary incontinence
Alpha-adrenergic antagonists are used to treat benign prostatic hyperplasia , high blood pressure and blood circulation problems. They affect smooth muscle and therefore can weaken the bladder.
Alpha-adrenergic agonists may contract the bladder neck and thus cause overflow incontinence. Clonidine, a drug for hypertension, is a common example of this class of drug.
Antipsychotics that contain phenothiazine inhibit the action of dopamine, disrupting the communication between the brain and the bladder and causing urge incontinence. These drugs are also used to treat anxiety disorders.
Antidepressants. All antidepressants cause urinary retention and overflow incontinence.
Diuretics, also called water pills, are a common treatment for high blood pressure. They increase the formation of urine in the kidneys in order to rid the body of salt and water. The need to urinate can be frequent and intense, causing urge incontinence.
Calcium channel blockers lower blood pressure by making the bladder muscle less able to contract, leading to overflow incontinence.
ACE inhibitors are blood pressure meds that tell the kidneys not to hang on to extra fluid. This can cause stress incontinence when the bladder is not able to hold urine during physical movement.