Urinary incontinence: pharmacotherapy options

Ann Med. 2011;43(6):461-76. doi: 10.3109/07853890.2011.564203. Epub 2011 Jun 3.

Abstract

The impact of incontinence is felt by millions of people worldwide, with tremendous decrement in quality of life and enormous cost reaching billions of dollars. Urinary incontinence is defined as 'involuntary leakage of urine' and is categorized into two main types: urgency urinary incontinence (UUI) and stress urinary incontinence (SUI). Behavioral modifications and pharmacologic therapies, primarily antimuscarinic agents, are the mainstay of treatment for UUI. These drugs are moderately efficacious but have troublesome side-effects, the combination resulting in poor compliance and persistence with therapy. There are several agents on the market today, each with some variation in pharmacologic properties. Whether these translate into meaningful differences in clinical efficacy and tolerability remains a matter of debate. Treatment of SUI has seen little success with pharmacologic therapy. In Europe, duloxetine is approved for treatment of SUI with marginal success rates; this drug, although available in the United States for treatment of depression, is not approved for SUI. The search for newer and better pharmacologic options and novel therapies is on-going, fueled primarily by the high prevalence of bothersome incontinence and the tremendous number of health care dollars spent on current therapy. This review addresses pharmacologic options for treatment of urinary incontinence.

Publication types

  • Review

MeSH terms

  • Adrenergic Uptake Inhibitors / adverse effects
  • Adrenergic Uptake Inhibitors / therapeutic use
  • Animals
  • Drug Approval
  • Duloxetine Hydrochloride
  • Humans
  • Muscarinic Antagonists / adverse effects
  • Muscarinic Antagonists / therapeutic use
  • Quality of Life*
  • Serotonin Uptake Inhibitors / adverse effects
  • Serotonin Uptake Inhibitors / therapeutic use
  • Thiophenes / adverse effects
  • Thiophenes / therapeutic use
  • Urinary Incontinence, Stress / drug therapy*
  • Urinary Incontinence, Stress / economics
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Urge / drug therapy*
  • Urinary Incontinence, Urge / economics
  • Urinary Incontinence, Urge / physiopathology

Substances

  • Adrenergic Uptake Inhibitors
  • Muscarinic Antagonists
  • Serotonin Uptake Inhibitors
  • Thiophenes
  • Duloxetine Hydrochloride