Definition
"Urinary incontinence" is defined as an "involuntary loss of" urine, which occurs suddenly, usually following a little effort, a cough or an "activity; we are talking about a condition that mainly affects the female world , although it may also involve men.This condition is not always a lit indicator of pathology, despite the fact that it constitutes an embarrassing, hygienic and relational problem.
Urinary incontinence should not be confused with overactive bladder, in which there is an urgent and frequent urge to urinate.
Causes
Urinary incontinence can be favored by some physiological conditions (eg menopause, pregnancy, childbirth), by the administration of certain foods / substances (alcohol, caffeine, antihypertensive drugs, muscle relaxants, sedatives) and by some pathologies, such as infections of the urinary tract, liver stones, prostate or liver cancer, neurological disorders, prostatitis, multiple sclerosis, intestinal obstruction.
The information on Incontinence - Urinary Incontinence Treatment Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Incontinence - Urinary Incontinence Treatment Drugs .
Medicines
Urinary incontinence should not be considered a pathology, but a symptom that unites a rather large number of diseases or physiological conditions. In menopause, for example, the woman undergoes physical transformations also at the bladder level, such as to modify the structures involved in the "expulsion of" urine; therefore, the woman may complain of urinary incontinence.
The treatment of urinary incontinence clearly depends on the underlying cause, as well as the severity of the condition, the age of the subject and the type of incontinence. For example, stress urinary incontinence does not always require drugs to be cured, unlike the form derived from an "instability of the detrusor muscle: in the latter case, the" incontinence derives from involuntary contractions of this muscle, also responsible for uncontrolled nocturnal urinary losses (nocturia). Often times, the affected patient from this problem he must practice special conservative exercises, aimed at strengthening the muscles of the bladder and pelvic floor.
Similar exercises are indicated to strengthen both the urinary sphincter and the pelvic floor muscles, involved in the control of urination; these exercises are indicated for both the treatment of stress incontinence and urge incontinence.
Exercises to strengthen the pelvic floor muscles are called Kegel exercises: they are performed simply by imagining to interrupt the flow of urine, contracting the pubococcygeus muscle for a few seconds. It seems that these exercises can also help to amplify sexual pleasure.
When these exercises are not sufficient to prevent urinary incontinence, certain medications such as estrogen (topically applied), anticholinergics, imipramine and SSRIs may be helpful.
If the problem is not solved even by resorting to drugs, the patient undergoes medical treatments that involve the insertion of small disposable devices (urethral insert) into the urethra, to prevent urine leakage. pessary it is useful for this purpose: it is a vaginal ring (not to be confused with the contraceptive one) which, by supporting the bladder, prevents urinary losses. Catheterization can also be an "alternative to treat" severe urinary incontinence.
To alleviate socio-relational discomfort, by not acting on the cause, it is recommended to wear special pads or diapers.
The following are the classes of drugs most used in the therapy for urinary incontinence, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the state health of the patient and his response to treatment:
Antimuscarinics or anticholinergics-antispasmodics: particularly indicated for the treatment of urinary incontinence: these drugs, by relaxing the detrusor muscle, increase the functionality of the bladder by reducing the uncontrolled contractility of the muscle. It is advisable not to take the same drug for more than 3-6 months of therapy.
- Oxybutynin (eg Kentera, Lyrinel, Ditropan): acts with a direct relaxing effect on the urinary smooth muscle. It is advisable to prefer slow-release formulations, which are equally effective as the standard ones, but with fewer side effects. The drug is also available in the form of a transdermal patch, to be applied twice a week to dry, cleansed skin. It is recommended to change the position of the patch with each application.
- Darifenacin (eg Emselex): indicated for the control of urinary urinary incontinence and pollakiuria. Available in slow-release tablets; it is recommended to take 7.5 mg of the drug once a day. Possibly double the dose in affected patients from severe incontinence.
- Solifenacin (eg Vesiker): the recommended dose for the treatment of urinary incontinence is 5 mg per day, possibly to be doubled in case of particularly heavy incontinence. It is not recommended for children.
- Tolterodine (eg. Detrusitol): for the treatment of urinary incontinence, it is recommended to take 2 mg of the drug orally, twice a day. Alternatively, take 4 mg of the drug, once a day, formulated in tablets to For the maintenance dose: take 1-2 mg of the drug by mouth (immediate release tablets), twice a day or 4 mg of the drug in graduated release tablets.
- Hyoscyamine: it is a tropane alkaloid (extracted from belladonna) with antispastic activity, indicated for the treatment of infantile urinary incontinence. For children aged between 2 and 12 years, it is recommended to take the drug in tablets at slow release, at a dose of 0.0625-0.125 mg, to be taken sublingually, orally or as chewable tablets. Repeat administration every 4 hours, as needed. Do not exceed 6 tablets per day. form of elixir: 1.25-5 mg every 4 hours for children weighing 10-50 kilos; increase the dose by 1.25 ml for every 20 kilos (starting at 50 kilos) Consult your doctor.
- Trospium or trospium chloride (eg. Uraplex, Sanctura, Urivesc): antispasmodic urinary drug used in the treatment of urinary incontinence. When formulated in immediate-release tablets, take 20 mg, orally, twice a day; for tablets slow-release, we recommend 60 mg, to be taken orally, in the morning, in a single administration. For the treatment of urinary incontinence in the elderly, the recommended dose suggests taking 20 mg (up to 75 years) of the drug per day, in slow-release tablets.
Selective serotonin reuptake inhibitors: indicated for the treatment of moderate or severe stress urinary incontinence. It is recommended to combine exercises to reinvigorate the pelvic floor.
- Duloxetine (eg Yentreve, Cymbalta, Xeristar, Ariclaim): it is recommended to take 40 mg of the drug twice a day. After 2-4 weeks of treatment, it is recommended to evaluate the response to treatment and tolerance to the drug.
Tricyclic antidepressants: at one time these drugs were much more used in therapy for the control of stress urinary incontinence; to date, they are used in therapy only rarely, due to the considerable side effects. However, for this purpose it can be taken imipramine (eg Imipra C FN, Tofranil). For the treatment of infantile nocturnal urinary incontinence (up to 12 years), it is recommended to administer 25 mg of the drug per day, one hour before breakfast. For children over 12 years of age with nocturnal urinary incontinence, the dose can be increased up to 75 mg per day. Consult your doctor.
