Pharmacological Treatment of Urinary Incontinence

Abstract

We present an overview of the current pharmacological treatment of urinary incontinence (UI) in women, according to the latest evidence available. After a brief description of the lower urinary tract receptors and mediators (detrusor, bladder neck, and urethra), the potential sites of pharmacological manipulation in the treatment of UI are discussed. Each class of drug used to treat UI has been evaluated, taking into account published rate of effectiveness, different doses, and way of administration. The prevalence of the most common adverse effects and overall compliance had also been pointed out, with cost evaluation after 1 month of treatment for each class of drug. Moreover, we describe those newer agents whose efficacy and safety need to be further investigated. We stress the importance of a better understanding of the causes and pathophysiology of UI to ensure newer and safer treatments for such a debilitating condition.

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

“…Usage could result in thirst, uncontrolled urination, urination constipation and other adverse reactions, so, single use of such drugs could increase incidence of urinary retention. Currently, obstruction relief drugs were given or operation was performed to improve symptoms, two researches TSUJIMURA [10] and KAPLAN [11] showed that the Hu/Zhang/Guan combined use of α1-adrenergic receptor blockers and M receptor blocker was more reliable in clinical safety and could reduce the incidence of urinary retention [12][13][14], while single use of α1-adrenergic receptor blockers had better curative effects and less adverse reactions than combined use in treating OAB, so, anticholinergic agents or combined use of other drugs were the first choice in clinic. TURP was common in treating OAB in clinic.…”

Advances in the molecular pathogenesis and cell therapy of stress urinary incontinence

“…These findings suggest that 5HT- 2C activation of the receptor could actively enhance urethral closure during sneezing. In addition to duloxetine, imipramine, which is a norepinephrine and serotonin reuptake inhibitor, is thought to improve urethral smooth muscle contraction for the treatment of SUI or mixed urinary incontinence ( Cipullo et al, 2014 ). Moreover, venlafaxine (0.1–10 mg/kg) and S-norfluoxetine (0.01–10 mg/kg) have also been shown to increase bladder volume, but they have not shown a clear therapeutic effect on SUI.…”

Screening and Treating Urinary Incontinence in Primary Care: A Missed Opportunity

“…Anticholinergic medications competitively inhibit acetylcholine at postganglionic muscarinic receptors, resulting in smooth muscle relaxation in the bladder (and other organs) [48]. Common side effects include dry eyes, dry mouth, constipation, urinary retention, dizziness, and blurry vision [22,31,49]. Long-term cumulative anticholinergic use is correlated with an increased risk of all-cause dementia and Alzheimer's disease, and prescribers should be comfortable counseling about these side effects [22,31].…”