Urinary incontinence, treatment

OPC-51803 is a highly selective V2R agonist and may prove useful for the treatment of CDI, urinary incontinence, enuresis and pollakiuria. It has a much higher bioavailability after oral application than desmopressin. 

After 3 years of treatment, CN has had one additional relapse, but otherwise is doing fairly well. At her routine clinic appointment, she describes some difficulty walking due to leg spasticity and urinary incontinence episodes that occur about twice a week. 

List the treatment goals for a patient with urinary incontinence or pediatric enuresis. 

Nonpharmacologic treatment can allow the use of lower drug doses. The combination of both therapies may have at least an additive effect on urinary incontinence signs and symptoms. 

In overflow urinary incontinence due to obstruction, the goal of treatment is to relieve the obstruction. 

Guay DRP. Trospium chloride an update on a quaternary anticholinergic for the treatment of urge urinary incontinence. Ther Clin Risk Manag 2005 1 157-166. 

Substituted 3,4-dihydropyrimido[l,2- ]pyrimidines and the benzologues 3,4-dihydropyrimido[l,2- ]quinazolines have opiate and NMDA receptor inhibitory activity and have been claimed for treatment of pain and urinary incontinence <2002W0030934>. 

In addition to treating MDD [51-53], duloxetine was approved as the first agent for the treatment of painful diabetic neuropathy in the U.S. [54-56]. It also has been used for stress urinary incontinence in women in Europe [57,58]. In 2007, duloxetine was approved for the treatment of generalized anxiety disorder in the U.S. 

Among elderly women as much as 80% suffer from involuntary voiding of the bladder, urinary incontinence (UI). In the United States approximately 12.5 million people are affected by incontinence and a European study showed a prevalence of between 12% and 22% in all ages and an increase to 30-40% in ages over 75 years (Hampel et al. 1997). Women experience UI twice as often as men. Incontinence becomes more common in old age, with existing co-morbidity of all kinds and life styles (Box 5.5). There are different forms of urinary incontinence and they differ in cause and treatment. This problem causes not only personal distress but also a considerable cost for society as a whole (Jackson 1997). Lower quality of life is often reported in people with UI and the risk increases by the withdrawal from social interaction and participation in sports and other activities. An estimated cost for the care of patients with UI in the United States was approximately 26 billion dollars in year 1995 (Wagner and Hu 1998). Other studies have come up with a calculated cost that represents two percent of the total national health budget. 

Both females and males experience age-related problems from the urinary tracts, for example prostate hypertrophy in men and urinary incontinence in women. Kidney problems become more frequent in old age not only because of the normal functional decline but as a result of diseases associated with aging, and their treatment. 

Urinary incontinence can be caused and worsened by drug treatment for diverse chronic conditions and should be treated with a multifactor aim... 

Overactive bladder For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary freguency. 

TAK-637 is a potent and selective neurokinin NKi antagonist being studied (Phase II) for its potential in the treatment of urinary incontinence (Figure 8.81). 

Unlabeled Uses Treatment of chronic pain syndromes, fibromyalgia, stress incontinence, urinary incontinence... 

Geriatric Considerations - Summary Compared to placebo, duloxetine is effective for the treatent of depression and painful diabetic neuropathy Few head-to-head studies are available comparing duloxetine to other agents in the treatment of depression or painful neuropathy. Because this agent may increase urethral sphincter activity, it is now being assessed as an agent for the treatment of stress urinary incontinence. This same property may increase the risk of urinary retention, although this has not been well documented. Duloxetine has not been well studied with respect to falls. 

Schuessler B, Baessler K. Pharmacologic treatment of stress urinary incontinence expectations for outcome. Urology 2003 62 31-38. 

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