How do medications treat urinary incontinence?

Prescription medications are an increasingly common way of treating overactive bladder (frequent urination and urges to urinate and leaking on the way to the toilet). Although medication has been available for decades, older drugs often had disappointing results or intolerable side effects. Changes have made several drugs for overactive bladder much easier to use.

Although there are no medications designed specifically to treat stress incontinence (leaking when coughing or jumping), certain drugs occasionally help with the symptoms, and others are useful for both urge and stress symptoms. In men who have overflow incontinence caused by an enlarged prostate, medications to shrink the prostate may help. Patients and clinicians can work together to find the medication that results in the fewest side effects, at the lowest dose that eases symptoms. This may take some trial and error.

Before starting any new medication, inform your doctor about any other drugs you are taking. Some medications may be unsafe or ineffective when combined with an incontinence medication. Before prescribing a medication for incontinence, your doctor will also want to make certain that no other drug you are taking could be causing your incontinence. If so, changing that prescription might solve the problem without introducing a new medication.

Along with medication, your doctor may suggest you use Kegel exercises (exercises for the pelvic floor muscles) to improve the strength and control of your pelvic floor muscles, along with bladder training and other behavioral strategies to suppress urgency. In a 237-woman trial comparing the medication tolterodine given alone or with training in behavioral techniques, women receiving the combination achieved better bladder control and were more satisfied with their treatment. However, most were not able to discontinue their medication and sustain the benefits.