Thursday, March 28, 2024

Medicines That Cause Urinary Incontinence

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What Steps Can I Take At Home To Treat Urinary Incontinence

Treatment Options for Male Urinary Incontinence

Your doctor or nurse may suggest some things you can do at home to help treat urinary incontinence. Some people do not think that such simple actions can treat urinary incontinence. But for many women, these steps make urinary incontinence go away entirely, or help leak less urine. These steps may include:

You can also buy pads or protective underwear while you take other steps to treat urinary incontinence. These are sold in many stores that also sell feminine hygiene products like tampons and pads.

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What Is The Treatment For Urinary Incontinence

Specific treatment for urinary incontinence will be determined by your doctor based on:

  • Your age, overall health and medical history

  • Type of incontinence and extent of the disease

  • Your tolerance for specific medications, procedures or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Behavioral therapies:

  • Bladder training: Teaches people to resist the urge to void and gradually expand the intervals between voiding.

  • Toileting assistance: Uses routine or scheduled toileting, habit training schedules and prompted voiding to empty the bladder regularly to prevent leaking.

  • Diet modifications: Eliminating bladder irritants, such as caffeine, alcohol and citrus fruits.

  • Pelvic muscle rehabilitation :

  • Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence.

  • Biofeedback: Used with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.

  • Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles.

  • Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions.

  • Medication :

  • Office procedure

  • Bladder suspension

  • Consult your doctor with questions regarding the management and treatment of urinary incontinence.

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    Mechanisms Of Urinary Continence

    In healthy individuals, the urinary bladder senses the volume of urine by means of distention. Distention of the bladder excites afferent A-delta fibers that relay information to the pontine storage center in the brain. The brain, in turn, triggers efferent impulses to enhance urine storage through activation of the sympathetic innervation of the lower urinary tract . These impulses also activate the somatic, pudendal, and sacral nerves.1

    The hypogastric nerves release norepinephrine to stimulate beta3-adrenoceptors in the detrusor and alpha1-adrenoceptors in the bladder neck and proximal urethra. The role of beta3-adrenoceptors is to mediate smooth-muscle relaxation and increase bladder compliance, whereas that of alpha1-adrenoceptors is to mediate smooth-muscle contraction and increase bladder outlet resistance.1 The somatic, pudendal, and sacral nerves release acetylcholine to act on nicotinic receptors in the striated muscle in the distal urethra and pelvic floor, which contract to increase bladder outlet resistance.1

    Efferent sympathetic outflow and somatic outflow are stopped when afferent signaling to the brain exceeds a certain threshold. At this point, the parasympathetic outflow is activated via pelvic nerves. These nerves release acetylcholine, which then acts on muscarinic receptors in detrusor smooth-muscle cells to cause contraction. A number of transmitters, including dopamine and serotonin, and endorphins are involved in this process.1

    Medications That Make Your Bladder Work Overtime

    Urinary Incontinence: Urologic and Medication Etiology in Seniors

    If you live with urinary incontinence, I dont have to tell you how inconvenient it is. The mad dash to the bathroom after a long car trip. Waking from a deep sleep with an uncontrollable need to urinate.

    Not having control over your bladder is a problem that can come to dominate your life.

    Urinary incontinence in women is generally attributed to problems with muscles and nerves in the bladder. For men, the culprit is often prostate-related.

    But did you know that the medication youre taking for a completely unrelated condition could be causing your leaky bladder?

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    What Are The Symptoms Of Urinary Incontinence

    The following are common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:

    • Needing to rush to the restroom and/or losing urine if you do not get to the restroom in time

    • Urine leakage with movements or exercise

    • Leakage of urine that prevents activities

    • Urine leakage with coughing, sneezing or laughing

    • Leakage of urine that began or continued after surgery

    • Leakage of urine that causes embarrassment

    • Constant feeling of wetness without sensation of urine leakage

    • Feeling of incomplete bladder emptying

    The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

    How Do I Do Kegel Exercises

    To do Kegels:

  • Lie down. It may be easier to learn how to do Kegels correctly while lying down. You dont have to lie down once you learn to do Kegels correctly.
  • Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks .
  • Relax.Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 each day.
  • Practice Kegels anywhere. When your muscles get stronger, try doing Kegels while sitting or standing. You can do these exercises at any time, such as while sitting at your desk or in the car, waiting in line, or doing the dishes. Dont do Kegel exercises at the same time you are urinating. This can weaken your pelvic floor muscles over time.10
  • If you are uncomfortable or uncertain about doing Kegel exercises on your own, a doctor or nurse can also teach you how to do Kegels. A pelvic floor physical therapist or other specialist may also be available in your area to help teach you how to strengthen these muscles.

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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 arent 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 Is Urinary Incontinence Diagnosed

    Urinary Incontinence (Stress, Urge, Overflow & Functional) | Causes, Symptoms, Diagnosis, Treatment

    For people with urinary incontinence, it is important to consult a health care provider. In many cases, patients will then be referred to an urogynecologist or urologist, a doctor who specializes in diseases of the urinary tract. Urinary incontinence is diagnosed with a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples.

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    What Causes Urinary Incontinence

    Urinary incontinence is not an inevitable result of aging, but it is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop urinary incontinence during pregnancy and after childbirth, or after the hormonal changes of menopause.

    Are Your Medications Causing Urinary Incontinence

    In theory, prescribing diuretics, muscle relaxants, antidepressant medications, and even nasal decongestants may promote urinary incontinence in some patients. The side effects of these drugs are usually temporary, but it is imperative to talk to your doctor about this problem, especially if you have urinary problems related to your prostate.

    Diuretic drugs

    It is easy to see why diuretics can promote urinary incontinence, their purpose being to increase the production of urine by your kidneys. By increasing the volume of your urine, diuretics promote urge incontinence, which is the feeling of an urgent urge to urinate.

    Muscle relaxants drugs

    Besides increasing your urine volume, muscle relaxants work on your pelvic muscles and relax the urethra. They also promote urge incontinence along with a sense of urgency to have to go to the bathroom as soon as possible.

    Antidepressant médications

    Nasal decongestants drugs

    Over-the-counter nasal decongestants are also among the treatments for temporary urinary incontinence. Avoid or limit the way you use decongestants and antihistamines during colds and allergy flares, as they tighten the muscles that control your urine flow and can make urination more difficult or trigger stress incontinence when coughing, laughing, or performing physical effort.

    When in doubt, talk to your doctor.

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    Medications That Can Cause Urinary Incontinence

    Urinary incontinence, or the loss of bladder control, can be caused by various health conditions and physical changes, such as childbirth, changes in diet, infection, prostate issues, menopause, and neurological disorders. But there are also a number of medications can cause urinary incontinence in both men and women in a variety of different ways.

    Medication

    Diuretics such as hydrochlorothiazide , furosemide , bumetanide , triamterene with hydrochlorothiazide

    Increase urine production by the kidney

    Frequent urination, overactive bladder, stress incontinence

    Muscle relaxants and sedatives such as diazepam , chlordiazepoxide , lorazepam

    Cause sedation or drowsiness relax the urethra

    Frequent urination, stress incontinence, lack of concern or desire to use the toilet

    Narcotics such as oxycodone , meperidine , morphine

    Cause sedation or drowsiness relax the bladder, causing it to retain urine

    Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence

    Antihistamines such as diphenhydramine and chlorpheniramine

    Relax the bladder, causing it to retain urine

    Overflow incontinence

    Alpha-adrenergic antagonists such as terazosin , doxazosin

    Relax the muscle at the outlet of the bladder

    Leaking when coughing, sneezing, laughing, exercising, etc.

    From Better Bladder and Bowel Control, Harvard Health Publishing

    Image: Thinkstock

    Home Remedies For Urinary Incontinence

    Drugs Used To Treat 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 Do You Do If Your Medication Is Causing Incontinence

    For many people, the first sign of urinary incontinence encourages them to stop taking the medication they were on. However, this is not always the best option for your health. If it is not possible to discontinue the medication you are taking, urinary incontinence may be managed with a variety of pharmacologic options.

    Sleeping Pills And Incontinence

    Only a small percent of people with incontinence have a problem with bed-wetting, according to Anger, who estimates that about 10% of patients with incontinence wet the bed. However, sleeping pills may pose a problem for those with incontinence at night.

    “Sleeping pills can make things worse, because people don’t wake up ,” she says.

    As an alternative, cut down on caffeine so you sleep better on your own, Anger suggests.

    Sleep will come more easily if you keep a regular bedtime and wake-up schedule, according to the National Sleep Foundation. You can also develop a relaxing bedtime ritual, such as reading a book or listening to soothing music.

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    Other Bladder Control Medications

    If symptoms of urinary incontinence are thought to be caused by an enlarged prostate, different medications can be offered to reduce these symptoms. The prostate gland wraps around the urethra , and if it is enlarged, it could squeeze the urinary passage tight, making the emptying of bladder more difficult and incomplete.

    In brief, the following categories are available for the treatment of urinary symptoms caused by an enlarged prostate :

    • Alpha-blockers, terazosin , doxyzosin , alfuzosin , silodosin , and tamsulosin , work by relaxing the muscles around the urethra and prostate, thus, making urination more comfortable and complete. These medications start to relieve symptoms within a few weeks, but they do not affect the prostate size.
    • 5-alpha reductase inhibitors, finasteride and dutasteride , work by reducing the size of the prostate gland. They may take several months to become effective.

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    Urge Urinary Incontinence – CRASH! Medical Review Series
    DRUG NAME SIDE EFFECTS
    Once daily
    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.

    Neurotoxins

    Re-injection can be considered when the effect diminishes but not within three months of the last injection

    Estrogen

    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.

    Desmopressin

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    Urinary Incontinence In Women: What You Need To Know

    • Urinary incontinence is the accidental loss of urine.

    • Over 25 million adult Americans experience temporary or chronic urinary incontinence.

    • This condition can occur at any age, but it is more common in women over the age of 50.

    • There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.

    • Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.

    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.

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    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 bodys 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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