Treatment of Medical Causes of Incontinence
There are a number of medical approaches that can help reduce bladder incontinence.
Diuretic medications, often used in the treatment of hypertension, can increase the amount of urine produced by the body. If incontinence has been a major problem that started when you began taking diuretics, speak to your doctor about whether there are other options for managing your hypertension.
Diabetes may cause increased urination. Optimal blood sugar management helps reduce the excess urine production that frequently results from diabetes.
Urinary tract infections can irritate the bladder, causing episodes of incontinence. Typically, antibiotics are necessary to eliminate urinary tract infections.
Sexually transmitted diseases may spread to or near the urinary tract and cause irritation that triggers incontinence. The best management for this type of incontinence is medical treatment of the sexually transmitted infection itself.
Yeast infections, like urinary tract infections and sexually transmitted diseases, may also cause irritation of the urinary tract that triggers incontinence. As with other infections, once this is medically treated, the incontinence should resolve.
Medications For Treating Incontinence
There are several categories of medications that can help reduce incontinence. These include:
Anticholinergics- these medications work by reducing excessive muscle contraction of the bladder. Examples include oxybutynin, tolterodine, fesoterodine, trospium, darifenacin, and solifenacin.
Beta-adrenergic agonist mirabegron helps relax the bladder so that it can hold more urine without leaking.
Tricyclic antidepressants such as Imipramine and Amitriptyline can have anticholinergic well as alpha-adrenergic agonists action.
Estrogen therapy as a cream or in oral form has also been shown to help reduce urinary incontinence.
Sometimes, the treatment for bladder incontinence involves the use of medication that can be injected directly into the muscles that control the bladder. This includes botulinum toxin, with can help reduce incontinence in the setting of overactive bladder and bladder spasticity.
Acupuncture has also been used with mixed results.
There are a number of procedures that can help reduce incontinence. The optimal type of procedure depends on whether the initial cause of incontinence is related to something such as a muscular problem, a nerve problem, a tumor or an injury.
Surgical procedures include placement of nerve stimulators, supportive devices, removal of tumors, repositioning of the organs involved in urination, and repair of injuries.
Catheterization is the process of placing a hollow tube directly into the bladder so that urine can flow out. This is a method used for temporary problems with control of urination, such as in the post-surgical recovery period, as well as when there is a permanent or severe problem that cannot be otherwise medically or surgically managed.
Willis-Gray MG, Dieter AA, Geller. Evaluation and management of overactive bladder: strategies for optimizing care. Res Rep Urol. 2016 Jul 27;8:113-22