Urinary frequency and incontinence

Urinary Tract. Atropine and several synthetic antimuscarinics have been used to alleviate urinary frequency and incontinence caused by hypertonicity of the urinary bladder.13,17 Increased bladder tone results if the normal reflex control of bladder function is disrupted (i.e., the so-called neurogenic bladder syndrome) or a urinary tract infection irritates the bladder. Some people might also exhibit increased urinary... 

Urinary frequency and incontinence Same if chronically exposed... 

Bladder overactivity is known as urge UI (UUI) and is associated with increased urinary frequency and urgency, with or without urge incontinence. The detrusor muscle is overactive and contracts inappropriately during the filling phase. 

In a controlled study of 1529 adult outpatients with urinary frequency and UUI, tolterodine LA, an extended-release formulation of tolterodine tartrate, significantly decreased the mean number of weekly incontinence episodes (23% effect rate over placebo and 7% effect rate over tolterodine IR). Patient withdrawal rates did not differ significantly between the two active treatments, but dry mouth was observed significantly less often in patients taking the LA formulation than among those patients receiving the IR formulation. ... 

Flavoxate is a urinary tract and spasmodic/alicalinizer, which counteracts smooth-muscle spasms of urinary tract. It is indicated in symptomatic relief of dysuria, urgency, nocturia, suprapubic pain, frequency and incontinence associated with cystitis, prostatitis, urethritis, urethrocysti-tis/urethrotrigonitis. Flavoxate, a flavone derivative and urinary tract spasmolytic (100 to 200 mg p.o. t.i.d.), is used in the symptomatic relief of dysuria, frequency, urgency, nocturia, incontinence, and suprapubic pain associated with urologic, disorders. 

Patients with urinary frequency and urinary retention do benefit from urodynamical evaluation to determine the voiding pressures, the volume that triggers the void, the effect of abdominal pressure, and the volume of void. A urology nurse or a physician can prescribe appropriate medications to address the above issues. Urodynamics may be performed at the bedside by a trained nurse and can provide prompt information to assist with a plan to address incontinence. This examination will prevent unnecessary wetness and improve the continence outcomes. 

Sureshkumar P, Gumming RG, Craig CJ (2006) Validity and reliability of parental report of frequency, severity and risk factors of urinary tract infection and urinary incontinence in children. J Urol 175 2254-2262 Swithinbank LV, Carr JC, Abrams PH (1994) Longitudinal study of urinary symptoms and incontinence in local schoolchildren. Scand J Urol Nephrol 163 [Suppl] 67-73... 

Urinary incontinence (UI) is defined as the complaint of involuntary leakage of urine.1 It is often associated with other bothersome lower urinary tract symptoms such as urgency, increased daytime frequency, and nocturia. Despite its prevalence across the lifespan and in both sexes, it remains an underdetected and underreported health problem that can have significant negative consequences for the individual s quality of life. Patients with UI may be depressed due to a... 

Urinary frequency (greater than 8 micturitions/day), urgency with or without urge incontinence nocturia (greater than or equal to 2 micturitions/night) and enuresis may be present as well. 

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

Mechanism of Action A quaternary ammonium compound that has anticholinergic properties and that inhibits action of acetylcholine at postganglionic parasympathetic sites. Therapeutic Effect Reduces gastric secretions and urinary frequency, urgency, and urge incontinence. 

Tolterodine, a competitive muscarinic receptor antagonist, is considered first-line therapy in patients with urinary frequency, urgency, or urge incontinence. Controlled studies demonstrate that tolterodine is more effective than placebo and as effective as oxybutynin IR in decreasing the number of daily micturitions and increasing the volume voided per micturition. However, most studies have not shown a decrease in the number of daily UI episodes as compared with placebo. 

This may be found by routine urine testing of pregnant women or patients with known structural abnormalities of the urinary tract. Such infection may explain micturition frequency or incontinence in the elderly. Appropriate antimicrobial therapy should be given, chosen on the basis of susceptibility tests, and normally for 7-10 days. Amoxicillin or a cephalosporin is preferred in pregnancy, although nitrofurantoin may be used if imminent delivery is not likely (see below). 

Urinary frequency, urgency and incontinence flavoxate, tolterodine, oxybutynin (antimuscarinics) may be useful they may cause retention of urine if there is anatomical obstruction. The pain (with reflex muscle spasm) of an indwelling catheter may be alleviated by diazepam. 

Flavoxate (Urispas) is used for urinary frequency, tenesmus and urgency incontinence because it increases bladder capacity and reduces unstable detrusor contractions (see p. 543). 

Propiverine, tolterodine and trospium diminish im-stable detrusor contractions and are used to reduce urinary frequency, urgency and incontinence. 

Solifenacin succinate (Vesicare) was approved in late 2004 by FDA for the treatment of OAB with urge incontinence, nrgency, and urinary frequency. This agent was comprehensively reviewed and the data provided below come principally from thatpnblication. ... 

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