Urinary Incontinence due to Medications

Aka: Urinary Incontinence due to Medications, Medication Causes of Urinary Incontinence, Drug-Induced Urinary Incontinence

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II. Causes: Antihypertensive

  1. Diuretics
    1. Urge Incontinence
      1. High Urine Volumes with secondary Bladder Irritability and contractions
  2. Calcium Channel Blockers, Beta Blockers, ACE Inhibitors
    1. Overflow Incontinence
      1. Relaxes Bladder, decreases Bladder contractility
  3. Alpha-adrenergic Antagonists (e.g.Hytrin)
    1. Stress Incontinence
      1. Decreases Urethral sphincter tone
      2. However, alpha blockers reduce Overflow Incontinence in Benign Prostatic Hyperplasia
  4. Alpha Adrenergic Agonist ( Phenylpropanolamine, Pseudoephedrine, Phenylephrine)
    1. Overflow Incontinence
      1. Increases Urethral sphincter tone

III. Causes: Analgesic

  1. Opioids
    1. Overflow Incontinence
      1. Bladder relaxation, Fecal Impaction and sedation result in Urinary Retention
  2. Skeletal Muscle Relaxants
    1. Overflow Incontinence
      1. Bladder contraction inhibition and sedation result in Urinary Retention

IV. Causes: Neuropsychiatric

  1. Sedative-Hypnotic Medications
    1. Overflow Incontinence
      1. Sedation results in Urinary Retention
  2. Antipsychotic Medications, Antidepressants and antiparkinsonism medications
    1. Overflow Incontinence
      1. Bladder contraction inhibition results in Urinary Retention

V. Causes: Miscellaneous

  1. Alcohol
    1. Urge Incontinence
      1. High Urine Volumes with secondary Bladder Irritability and contractions
    2. Overflow Incontinence
      1. Bladder contraction inhibition and sedation result in Urinary Retention
  2. Antihistamines and Anticholinergics (including Bladder Antispasmodics)
    1. Overflow Incontinence
      1. Bladder contraction inhibition and sedation result in Urinary Retention
  3. Thiazolidinediones (Glitazones, Actos)
    1. Functional Incontinence
      1. Fluid retention and nocturnal diuresis

VI. References

  1. Khadelwal (2013) Am Fam Physician 87(8): 543-50 [PubMed]
  2. Imam (2004) Rev Urol 6(suppl 1): S38-44 [PubMed]

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