What do medications do for urinary incontinence?
Medications can play an important role in treating urinary incontinence by addressing various mechanisms in the body that contribute to incontinence. Here are some of the main modes of action and medication types:
Types of medications and their effects
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Anticholinergics
- Effect: These medications relax the bladder muscles and reduce involuntary bladder contractions.
- Examples: oxybutynin, tolterodine, solifenacin.
- Use: They are often used for urge incontinence (overactive bladder).
-
Beta-3 adrenoceptor agonists
- Effect: These medications help relax the bladder muscles and increase bladder capacity.
- Examples: Mirabegron.
- Use: Also used for urge incontinence and overactive bladder.
-
Estrogen preparations
- Effect: Topical estrogens (e.g. creams or vaginal suppositories) can strengthen bladder and urethral tissues and improve urinary incontinence in postmenopausal women.
- Examples: vaginal creams, suppositories or rings.
- Use: Often used for stress or urge incontinence in postmenopausal women.
-
Duloxetine
- Effect: This medication increases the activity of nerves that control the muscles of the urethra, thereby improving sphincter function.
- Examples: Duloxetine.
- Use: Mainly for stress incontinence.
-
Desmopressin
- Effect: Reduces urine production in the kidneys.
- Examples: Desmopressin.
- Use: For nocturnal polyuria (excessive urine production at night).
Side effects and considerations
- Anticholinergics: dry mouth, constipation, blurred vision, dizziness and cognitive impairment, especially in the elderly.
- Beta-3 adrenoceptor agonists: Increased blood pressure, headache, and gastrointestinal disturbances.
- Estrogens: Risk of breast cancer, stroke and thrombosis, especially with systemic use (not topical).
- Duloxetine: Nausea, dry mouth, drowsiness, and changes in blood pressure.
- Desmopressin: Risk of hyponatremia (low sodium levels in the blood).
Importance of medical monitoring
Choosing the right medication depends on the type of incontinence, individual symptoms, and the patient's overall health. A thorough medical examination and consultation with a specialist are crucial to achieving the best results and minimizing side effects.
In summary, medications for urinary incontinence can significantly improve quality of life by relieving symptoms and giving patients more control over their bladder. However, treatment should be individualized and regularly monitored.
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