Medications for Overactive Bladder

If you have overactive bladder or other urinary incontinence, there are several treatments available to you.  

It's helpful to first determine what type of incontinence you have:

Stress incontinence (which has nothing to do with mental stress) occurs when you laugh, sneeze or exercise.  It comes from weakened pelvic and sphincter muscles.

Urge incontinence refers to leaking urine after a strong urgent need to urinate.  It's often due to a medical condition that weakens your muscles, such as an infection or diabetes.

Overactive bladder also may involve a strong urgent need to urinate, as well as frequency — going to the bathroom eight times a day or more and getting up in the night two or more times.

Prolapsed or "dropped" bladder is a weakening of the vaginal wall that can cause incontinence.  This condition may require the insertion of a sling device or surgery.

For any of these conditions, the first thing to try is behavior management and exercise. You may find that techniques such as bladder retraining, to lessen urinary frequency, and Kegel exercises, to tighten your pelvic muscles, will be enough to keep your problem in check.  Some studies have shown these techniques to be even more effective than drugs.

But some women find it hard to stick to the exercise regimen.  If these measures aren't working for you for whatever reason, there are several medications that your doctor may prescribe that can help, depending on the type of incontinence you have. According to the National Kidney and Urologic Diseases Information Clearinghouse, there are no medications for stress incontinence. For overactive bladder and urge incontinence, though, there are several.  

Antispasmodics or anticholinergics, work to calm an overactive bladder.  These include:

• tolterodine (Detrol)
• oxybutynin chloride (Ditropan)
• darifenacin (Enablex)
• hyoscyamine (Levsin)
• trospium chloride (Sanctura)
• solifenancin succinate (VESIcare)

Topical estrogen help tones the area around your vagina which may help with incontinence.

Tricyclic antidepressants, used primarily for depression, may also help with incontinence.

Some experts suggest a combination of bladder retraining, Kegel exercises and medication. In one study, women who used the combination of behavior and the medication oxybutynin chloride were able to achieve an 89 percent reduction in incontinence.  In this same study, women who used behavioral treatment only had an 81 percent reduction, those who used the drug only had a 69 percent reduction and those in a control group had a 39 percent reduction.

With or without medication, the good news is that with persistence you will likely be able to significantly control your  bladder problem.