Don’t Suffer in Silence: Medications to Treat Incontinence

Did you know that the aver­age cost of incon­ti­nence (pads, laun­dry, clean­ing) is over $900 per year for a per­son who is deal­ing with an over­ac­tive blad­der? Plus adult dia­pers alone cost an aver­age $34 per week for patients who suf­fer from incontinence.

Over­ac­tive blad­der (OAB) is a con­di­tion con­sist­ing of fre­quent uri­na­tion, urgent uri­na­tion, and/​or unin­ten­tion­al loss of urine (incon­ti­nence) asso­ci­at­ed with urgency. Up to a third of men and almost half of women in the Unit­ed States report over­ac­tive blad­der symp­toms. Over­ac­tive blad­der can occur at any age.

You can seek relief from this cycle instead of ​“just deal­ing with it.” Treat­ment of over­ac­tive blad­der typ­i­cal­ly works in a step­wise man­ner begin­ning with the most con­ser­v­a­tive treat­ments and work­ing towards less con­ser­v­a­tive meth­ods if ini­tial treat­ment is ineffective. 

Stud­ies have shown that symp­toms can be improved with non-drug con­ser­v­a­tive inter­ven­tions that include:

• Spe­cial­ized pelvic floor mus­cle exer­cis­es (Kegels)
• Nor­mal­iz­ing weight if overweight
• Sched­ul­ing flu­id intake and timed voiding

How­ev­er, some peo­ple do not ben­e­fit from these non-drug treat­ments or are not able to make the nec­es­sary lifestyle changes. In this case, your physi­cian may sug­gest the use of med­ica­tions to help with incon­ti­nence problems.

The Food and Drug Admin­is­tra­tion (FDA) has approved sev­er­al med­ica­tions for those with fre­quent urges to uri­nate. After lifestyle changes, med­ica­tions are usu­al­ly the next line of defense for over­ac­tive blad­der symp­toms. Med­ica­tions work to relax the blad­der, which leads to few­er invol­un­tary blad­der con­trac­tions. When there is less of this chem­i­cal in your body, you have few­er invol­un­tary blad­der con­trac­tions. These med­ica­tions can increase the amount of urine void­ed but also decrease your feel­ing of urgency.

Sci­en­tif­ic research has shown that sev­er­al med­ica­tions for urge incon­ti­nence may ben­e­fit peo­ple who have not achieved opti­mal con­ti­nence with non-drug inter­ven­tions. These drugs include:

• Toltero­dine (Detrol)
• Oxy­bu­tynin (Ditropan XL)
• Oxy­bu­tynin as a skin patch (Oxytrol)
• Oxy­bu­tynin gel (Gel­nique)
• Tro­spi­um (Sanc­tura)
• Solife­nacin (Vesi­care)
• Dar­ife­nacin (Enablex)
• Fes­otero­dine (Tovi­az)
• Mirabegron (Myr­be­triq)

How­ev­er, these drugs may cause adverse effects including:

• Dry mouth and eyes
• Con­sti­pa­tion
• Blurred vision or headaches
• Oth­er less com­mon side effects

Each of the drugs list­ed above have slight­ly dif­fer­ent side effects. It is impor­tant to be hon­est with your physi­cian as to how the med­ica­tion is impact­ing your dai­ly life. If there are cer­tain side effects that are intol­er­a­ble, a dif­fer­ent med­ica­tion may be bet­ter for you. Some­times treat­ing the side effects of a med­ica­tion that works for you can be more impor­tant than stop­ping the med­ica­tion. Patients should also be aware that it takes time to see results from any of these med­ica­tions and should eval­u­ate progress over 30 days.

If con­ser­v­a­tive meth­ods and med­ica­tions don’t work for you, there are FDA-approved advanced ther­a­pies avail­able to help you gain con­trol of your bladder.