Urinary incontinence impacts millions of American men and women. Often times the solution may be to have your doctor check your medications and see if the medications may be the culprit.
There are four groups of medications doctors commonly recommend that can cause or increase incontinence. If you are taking any of these, you should let your doctor know about your incontinence and discuss your medications (both prescription and over-the-counter) to see if there is another approach to control or eliminate the problem.
The most common incontinence problems arise from medications in the following four categories:
1. Diuretics to reduce excess fluid
Diuretics, also known as “water pills,” stimulate the kidneys to expel unneeded water and salt from your tissues and bloodstream into the urine. Getting rid of excess fluid makes it easier for your heart to pump. There are a number of diuretic drugs, but one of the most common is furosemide (Lasix®).
Approximately 20 percent of the U.S. population suffers from overactive bladder symptoms which consists of urgency of urination and loss of urine when the man or woman cannot reach the toilet in a timely fashion.
Many of those patients also have high blood pressure or vascular conditions, such as swelling of the feet or ankles. These conditions are often treated with diuretic therapies that make their bladder condition worse in terms of urgency and frequency.
A first step is to make sure you are following your doctor’s prescription instructions exactly. As an alternative to water pills you might try restricting salt in your diet and exercising for weight loss. Both of these can reduce salt retention and hypertension naturally. Also, if you take diuretics, use them in the morning so you have frequency during the day and not at night after you go to sleep.
2. Alpha blockers for hypertension
Another class of drugs used to reduce high blood pressure or hypertension by dilating your blood vessels can also cause problems. These medicines are known as alpha blockers. Some of the most common are Cardura®, Minipress® and Hytrin®.
Men typically take these to treat an enlarged prostate (benign prostatic hyperplasia or BPH) which can restrict urination by putting pressure on the urethra. By relaxing the muscles in the bladder neck, alpha blockers allow smoother urine flow for those patients but may result in incontinence.
3. Antidepressants and narcotic pain relievers
Some antidepressants and pain medications can prevent the bladder from contracting completely so that it does not empty. That gives rise to urgency or frequency or voiding dysfunction. They can also decrease your awareness of the need to void.
Some of these drugs can also cause constipation. Constipation, in turn, can cause indirect bladder incontinence because being constipated takes up more room in the pelvis that the bladder needs to expand. Also, a full rectum can press on the bladder and result in stimulation of the bladder to contract and result in urgency and frequency as well as incontinence.
4. Sedatives and sleeping pills
Using sedatives and sleeping pills can present a problem, especially if you already have incontinence. They can decrease your awareness of the need to void while you are sleeping.
The best way to address this situation is to take other steps to relax and improve your sleep. Getting more exercise earlier in the day to make you tired, for example, can help. It’s also important to maintain a regular bedtime and wake-up schedule. Try to find other ways to relax before bed — meditation, reading a book or listening to soothing music or sound effects (e.g., rain or waves) — can also help you sleep better.
Bottom line: the side effects of medication can result in urinary incontinence. If you think this is a problem, check with your physician.
Dr. Neil Baum's Urology Blog 