pharmaceutical causes of urinary incontinence

^[1]^[2]^[3]^[4]^[5]

Etiology

pharmaceuticals with anticholinergic effects
- potential effects on continence
- examples
parasympathomimetics
- potential effects on continence
  - detrusor instability
  - urge incontinence
- examples
  - cholinesterase inhibitors
  - nicotine
loop diuretics
- potential effects on continence
  - polyuria
  - frequency
  - urgency
- examples
  - furosemide (Lasix)
  - bumetanide (Bumex)
sedative/hypnotics
- potential effects on continence
- examples
  - long-acting benzodiazepines (diazepam, flurazepam)
alcohol
- potential effects on continence
  - polyuria
  - frequency
  - urgency
  - sedation
  - delirium
  - immobility
caffeine -> worsening or precipitation of urge incontinence
opiates
- potential effects on continence
alpha-adrenergic agonists (esp. in men with BPH*)
- potential effects on continence
  - urinary retention in men
- examples
  - sympathomimetics
  - decongestants
alpha-adrenergic antagonists (women)
- potential effects on continence
  - urethral relaxation may precipitate stress incontinence in women
- examples
  - prazosin (Minipress)
  - terazosin (Hytrin)
  - doxazosin (Cardura)
beta-adrenergic receptor agonists -> urinary retention^[3]
calcium channel blockers
- potential effects on continence
  - urinary retention
  - nocturnal diuresis due to fluid retention
- examples
  - all dihydropyridines
    - amlodipine, felodipine, isradipine, nimodipine, nifedipine, nicardipine, nisoldipine, nitrendipine
angiotensin-converting enzyme (ACE) inhibitors
- potential effects on continence
  - drug-induced cough can precipitate stress incontinence in women & some men with prior prostatectomy
  - cough with relaxation of pelvic floor^[3]
- examples
thiazolidinedione (glitazone)
- potential effects on continence
  - edema resulting in nocturnal polyuria^[3]
- examples
  - pioglitazone
  - rosiglitazone
  - triglitazone
NSAIDs: - edema resulting in nocturnal polyuria^[3]
GABAergic agents
- potential effects on continence
  - edema resulting in nocturnal polyuria^[3]
- examples
  - gabapentin
  - pregaballn
estrogens worsen stress incontinence
chemotherapeutic agents
- vincristine may cause urinary retention

* Benign Prostatic Hypertrophy

Additional terms

urinary incontinence (UI)

References

↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 41
↑ ^3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
↑ Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
↑ Erdem M & Chu FM Management of overactive bladder and urge urinary incontinence in the elderly patient. Am J Med 2006;119(3A):295

[ref1-1] Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998

[ref2-2] Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 41

[ref3-3] 3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010

[ref4-4] Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society

[ref5-5] Erdem M & Chu FM Management of overactive bladder and urge urinary incontinence in the elderly patient. Am J Med 2006;119(3A):295

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pharmaceutical causes of urinary incontinence

Etiology

Additional terms

References

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