title: Medical and minimally invasive treatment of urinary incontinence.
abstract: Newer agents and procedures give urologists more options in treating patients who have urinary incontinence related to such etiologies as an ineffective sphincter, detrusor hypersensitivity, obstruction, or a combination of these. Abolition of the involuntary contractions characteristic of detrusor instability can be accomplished pharmacologically or surgically. First-line anticholinergic agents are tolterodine and oxybutynin XL, given orally. Alternatively, intravesical administration provides a high concentration of drug, such as capsaicin or resiniferatoxin, at the detrusor muscle level. However, this commits the patient to intermittent self-catheterization. Surgery is reserved for those who have failed prolonged trials of conservative therapies. For patients with intractable urge incontinence, urologists have the new technique of sacral nerve stimulation.
authors.forename: J P
authors.initials: JP
authors.lastname: Lavelle
authors.forename: S
authors.initials: S
authors.lastname: Teahan
authors.forename: D Y
authors.initials: DY
authors.lastname: Kim
authors.forename: M B
authors.initials: MB
authors.lastname: Chancellor