Adult Urinary Incontinence: More Common then You Think

Contributed by: Alan Schoenike, Pharm.D. Candidate

UMKC School of Pharmacy

Text Box: What is Adult Urinary Incontinence? Adult urinary incontinence (UI) is defined as the involuntary release of urine that can lead to social or hygienic problems. This condition occurs in approximately 25 million people in the United States and is most common in elderly women. The condition can also occur in younger people, particularly women who are pregnant or have just given birth. UI can also occur in men although the risk is only half that of women. This condition can lead to skin infections, rashes and social difficulties. Many suffering from UI have to plan there day around trips to the bathroom or live in fear of having an “accident” in a public place. What are the types of UI? There are three main types of UI. One type is stress urinary incontinence (SUI). This type of incontinence occurs when extra pressure is applied to the bladder such as when someone sneezes, exercises, coughs, or lifts a heavy object. SUI is the most common type of incontinence seen in women. The second type is urinary urge incontinence (UUI). This incontinence occurs when the muscle surrounding the bladder squeezes inappropriately. UUI is characterized by a sudden and strong urge to urinate. Some estimates say as many as one in five adults over 40 have some symptoms of overactive bladder. The third type of UI is overflow incontinence. It is the least common and occurs when the urethra, the tube that carries urine out of the body, becomes blocked. This causes the bladder to fill with urine and then slowly leak out around the blockage. Although this type of UI is the least common, it can

Text Box: signify serious health conditions such as prostate cancer in men. Several different treatments are available for UI including both medications and surgery. What treatments are available for UI? Currently no medications are approved for the treatment of SUI. Some people perform Kegel exercises that help strengthen the muscles that control urination. These exercises can be very effective with mild SUI. Drugs such as Detrol® (tolterodine tartrate) and Ditropan® (oxybutin chloride) have long been available and Ditropan® is now available in a patch form for more convinent use. Sanctura® (trospium chloride), Enablex® (darifenacin) and Vesicare® (solifenacin succinate) have been approved in the past few years for the treatment of UUI as well. These medications all basically work the same by blocking the nerves that over stimulate the bladder to contract. Other medications such as Flomax® (tamsulosin HCl), Hytrin® (terazosin HCl), and Minipress® (prazosin HCl) and Avodart® (dutasteride) are available to help men with overflow incontinence due to benign prostatic hyperplasia (a non-cancerous enlargement of the prostate). These medications can help relax the urethra or help shrink the prostate to help urine flow more easily. DDAVP® (desmopressin acetate) is another medication that can be used for UI. It is usually dosed at night and helps limit the amount of urine produced to help people sleep through the night without the need to use the restroom.

Text Box: Several other medications can be used in the treatment of UI but are not approved and are only used in cases that do not respond to traditional therapy. In very severe cases surgical options are available to help control UI as well. Speaking with your health care professional Many people with UI are reluctant to speak with their physician. They may be embarrassed to discuss their lack of control or may feel that it is just part of getting older. Statistically women wait on average six and one half years and men four before reporting this treatable condition to their physician. Early treatment can significantly improve people’s quality of life. Not having to constantly look for where the closest bathroom is or worry about embarrassing public “accidents” can allow people to life a more full life. Ask your pharmacist or physician for more information about this disease. More information is available on the Web at www.fda.gov/fdac/features/2005/505_incontinence.html.