J Korean Med Assoc.  2016 Mar;59(3):215-220. 10.5124/jkma.2016.59.3.215.

Oral pharmacological therapy for urinary incontinence

• Kim DK

• KMID: 2382726
• DOI: http://doi.org/10.5124/jkma.2016.59.3.215

Abstract

Urinary incontinence (UI) has been a serious health problem which can significantly affect quality of life. UI may occur at any age but more common in the elderly population. Many conditions may leak to UI and differential diagnosis is critical to guide appropriate manage strategy. After a brief description of the pathophysiology, classification, and diagnostic evaluation of UI, this review highlights oral pharmacological therapy mainly in clinical point of view. For urge UI, antimuscarinic are the most commonly used medication supported with high level of evidence. Antimuscarinics competitively block muscarinic receptors with variations in selectivity for the different subtypes. Common adverse effects are dry mouth, constipation, and blurred vision. High caution for cognitive function should be applied in the use of antimuscarinics in the elderly. Mirabegron, a beta3-agonist, is a new class of drug targeting urge UI, which reported similar efficacy with antimuscarinics and favorable adverse effect profile. For stress UI, various type of medications have been clinically investigated but so far none showed satisfactory resolution of stress UI. Duloxetine is the only medication approved for stress UI in European countries but not in US Food and Drug Administration and Korean Food and Drug Administration due to low benefit-risk profile for UI. Conclusively, pharmacological therapy should be tailored to the type of UI. Recent options of medications may give further treatment possibilities for the optimal treatment for each patient.

Keyword

Urinary incontinence, urge; Urinary incontinence, stress; Medication therapy management

MeSH Terms

Aged
Classification
Constipation
Diagnosis, Differential
Drug Delivery Systems
Duloxetine Hydrochloride
Humans
Medication Therapy Management
Mouth
Muscarinic Antagonists
Quality of Life
Receptors, Muscarinic
United States Food and Drug Administration
Urinary Incontinence*
Urinary Incontinence, Stress
Urinary Incontinence, Urge
Muscarinic Antagonists
Receptors, Muscarinic

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