Medications
A number of medications are available that increase sphincter or pelvic muscle strength or relax the bladder, making it able to hold more urine. Medications are prescribed for all kinds of incontinence, but they are generally most helpful for urge incontinence.
Medications Specifically for Urge Incontinence
Anticholinergics. Anticholinergics work in the following ways:
- Inhibit the involuntary contractions of the bladder
- Increase capacity of the bladder
- Delay the initial urge to void
A major 2003 analysis reported that these drugs produce small but significant improvements. However, the medications have not been rigorously compared with behavioral methods, such as bladder training and Kegel exercises, which are very effective for most cases of urge incontinence. Anticholinergics can have distressing side effects, notably dry mouth.
Anticholinergics include:
- Propantheline (ProBanthine). This drug used to be the most commonly prescribed anticholinergic, but has been largely replaced by newer anticholinergics with fewer side effects.
- Oxybutynin (Ditropan, Oxytrol)
- Tolterodine (Detrol)
- Hyoscyamine (Levbid, Cystospaz)
Extended-release versions of oxybutynin (Ditropan XL) and tolterodine (Detrol LA) are proving to be especially effective. They improve continence and have fewer adverse effects than short-acting forms. According to one study of Detrol LA, the drug also improved quality of life. In a major 2003 comparison study of the extended release drugs, oxybutynin was slightly better than tolterodine, but dry mouth was reported more often. A skin patch form of oxybutynin (Oxytrol) is now available. It appears to work better and have fewer side effects, such as dry mouth and constipation, than the pill form. A 2006 study reported that tolterodine is helpful for men with overactive bladder and urge urinary incontinence.
Overactive Bladder Treatments for Children
- Oxybutynin (Ditropan X) is approved for pediatric use in children ages 6 and older. The recommended dose is 5 mg once a day. A 2006 study suggested that children who have fewer episodes of daytime wetting may benefit most from this drug.
- A 2004 analysis found that tolterodine is also effective and well tolerated in children with urinary symptoms due to overactive bladder.
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