Medicines and surgical treatments for urinary incontinence
As many as six million people in the UK have some degree of urinary incontinence, such as urge incontinence, stress incontinence and overactive bladder, according to the NHS. The condition affects around twice as many women as it does men and is more common with older age.
Losing weight, pelvic floor muscle training and bladder training may be recommended before other treatments are considered.
Here are some of the medicines and surgical treatments available for urinary incontinence:
Medication for stress incontinence
Duloxetine is a possible medication for stress incontinence which may be recommended for stress incontinence after other treatments have been tried.
This treatment is not suitable for everyone, including elderly people and those with heart disease or kidney problems.
Side effects can include constipation, diarrhoea, hot flushes, agitation, insomnia or sleepiness.
Medication for overactive bladder syndrome (OAB)
Antimuscarinics as a tablet or patch may be prescribed for overactive bladder syndrome, an urge to urinate frequently, sometimes with urinary incontinence.
Antimuscarinic options include oxybutynin, darifenacin, fesoterodine, flavoxate, propiverine, solifenacin, tolterodine and trospium.
These treatments are not suitable for people with angle closure glaucoma, myasthenia gravis or severe ulcerative colitis.
Side effects include dry mouth, constipation, indigestion, heartburn, blurred vision and dry eyes.
Mirabegron may be recommended when other treatments have not been effective or cause too many side effects. It is from a class of drugs called beta 3 agonists and works by stimulating certain receptors in the detrusor muscle of the bladder wall. This relaxes the muscle, meaning the bladder can hold more urine, reducing the need to go to the toilet as often.
It may not be suitable for some people including those with poorly controlled high blood pressure, those who have liver or kidney problems, and those on haemodialysis.
Side effects include faster heart rate, nausea, and urinary tract infection.
Medication for bedwetting
Desmopressin is a medication used to treat bedwetting at night.
Surgical treatment for urinary incontinence
If behavioural treatments and medication for urinary incontinence have not been successful, an operation or other procedures may be recommended. The decision to have surgery will be taken after the risks and benefits have been weighed up.
Procedures for stress incontinence
A sling procedure may help with stress incontinence. An incision is made in the lower abdomen and a sling is put around the neck of the bladder to support it. The material for the sling may come from another part of the body, donated or animal tissue, or a synthetic product.
With synthetic slings, there is a risk of causing difficulty urinating or urge incontinence.
Urethral bulking agents
This procedure involves injecting a bulking agent into the walls of the urethra connected to the bladder, helping the urethra to stay closed more effectively. Further treatments will be needed as the effectiveness wears off over time.