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How can alpha-adrenergic agonists help treat urinary incontinence?

Alpha-adrenergic antagonist medications are used for urinary incontinence in men due to benign prostatic hyperplasia (BPH), or an enlarged prostate. Men are typically started on these. They are alpha-blocker medications, known as tamsulosin (Flomax), doxazosin, (Cardura) and terazosin ((Hytrin). These medications help relax the swollen muscles in the bladder neck to increase the flow of urine.

Studies have shown that in 53 weeks of using these medications, there is about a 31% to 36% improvement in the flow rate versus 21% in people not taking any of the medications. Doctors assess this by using a uroflow machine where the man urinates into a funnel that measures his flow rate. It’s also based on people’s records of improvements in their symptoms. They feel like they have a better, easier time urinating.

With the combination of type II 5-alpha reductase inhibitor medications and alpha-adrenergic antagonist medications, a lot of men have improvement despite having an enlarged prostate gland.
Anthony L. Komaroff, MD
Internal Medicine
Alpha-adrenergic antagonists are prescribed to men who develop overflow incontinence when an enlarged prostate interferes with normal urine flow. Also known as alpha blockers, these drugs have the opposite effect of alpha-adrenergic agonists–they relax the smooth muscle of the urethra (the tube that connects the bladder to the outside of the body). They include doxazosin (Cardura), tamsulosin (Flomax), terazosin (Hytrin), silodosin (Rapaflo) and alfuzosin (Uroxatral).
Found in some popular cold medicines, alpha-adrenergic agonists are not designed specifically to treat incontinence. But women with stress incontinence and some men who have undergone prostate removal may find these medications help relieve their symptoms. Alpha-adrenergic agonists mimic the effects of the neurotransmitter norepinephrine, which, among other things, stimulates the muscles around the bladder neck (the junction of the bladder and the urethra) and urethra (the tube that connects the bladder to the outside of the body) to contract and form a tighter seal to keep urine in.

One alpha-adrenergic agonist, pseudoephedrine, is an ingredient in cold and allergy remedies such as Sudafed. Some people take pseudoephedrine occasionally to minimize stress incontinence. You should check with your doctor before taking pseudoephedrine especially if you have a heart condition or high blood pressure.

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