Urinary incontinence in the elderly: pharmacologic therapies.
Treatment of acute urinary incontinence should be directed toward the underlying cause, such as infection, medication side effect, atrophic vaginitis, anxiety, depression and restricted mobility. Pharmacologic treatment depends on identification of one of the four subtypes of chronic urinary incontinence: stress, urge, overflow or mixed. Stress incontinence responds to alpha-adrenergic agents, which increase sphincter tone. Urge incontinence is the most common type of incontinence in the elderly; it can be treated with anticholinergic agents, smooth muscle relaxants, estrogen replacement therapy in women and, possibly, calcium antagonists. Overflow incontinence is caused by neurologic deficits, such as diabetes, or outflow obstruction, such as from prostatic enlargement, urethral stricture and tumors. Anticholinergic agents and alpha-adrenergic agents should be considered only after existing outflow obstruction is surgically corrected or intermittent catheterization is unsuccessful.
Peggs
J F
JF
University of Michigan Medical School, Ann Arbor.
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D004967:Estrogens / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D010276:Parasympatholytics / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D014549:Urinary Incontinence / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*
D000316:Adrenergic alpha-Agonists; D000929:Antidepressive Agents, Tricyclic; D002121:Calcium Channel Blockers; D004967:Estrogens; D010276:Parasympatholytics