Incontinence Treatment

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Stress incontinence may be treated with phenylpropanolamine, a decongestant that can increase resistance in the urethra. If physical examination determines that the bladder neck has descended too low to be effective at holding back urine flow, surgery may be recommended to correct the problem. For menopausal and postmenopausal women, treatment with a topical estrogen cream may help.

Urge incontinence usually requires medical intervention to stabilize the detrusor muscle or the urethra. Medications commonly used for this purpose include oxybutinin, a type of drug classified as an antispasmodic; propantheline, an anticholinergic; or the tricyclic antidepressant imipramine. All of these drugs act to relax the bladder muscle. Possible side effects of oxybutinin include decreased sweating, with an increased risk of heatstroke, drowsiness, restlessness, hallucinations, constipation, nausea, dry mouth, and increased heart rate. Pro-Banthine can cause similar side effects. Tofranil can cause high or low blood pressure, increased heart rate, numbness, tremors, blood cell changes, drowsiness, sex drive decrease, and changes in blood-sugar level. A newer drug, tolerodine, works for urge incontinence by competing against muscle receptors that make the bladder contract, so that a larger volume of urine may be held. Possible side effects include dry mouth, digestive problems, headache, constipation, dry eyes, high blood pressure, dizziness, and blurred vision. This drug should not to be used if you suffer form urinary or gastric retention, or if you have narrow-angle glaucoma.

In cases of total incontinence, surgical reconstruction of the outflow tract may be possible. This may include artificial urinary sphincter placement or the injection of collagen around the urethra for support.

If an anatomical abnormally is causing anal incontinence, surgical repair may be indicated. If examination of the anal sphincter muscle shows it has a poorer than normal ability to contract, biofeedback therapy to train and strengthen the musculature may help.

If you regularly take any type of medication, whether prescription or over the counter, you may wish to review it with your doctor, since certain drugs can contribute to incontinence. It may be possible to change your prescription or alter the dosage on your own, however. Always consult with your physician first.

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