New Study Looks at Urinary Incontinence Drugs and Their Side Effects

Prescription drugs can sometimes be a double-edged sword. They relieve symptoms of a particular condition but can cause a whole new set of problems. Even worse, sometimes they not only cause side effects, they do not even work at all for some people. A recent study found that many urinary incontinence medications were only moderately effective and caused frequent side effects.

Study Overview

The study, carried out by the University Of Minnesota School Of Public Health and published in the April 10^th issue of Annals of Internal Medicine, reviewed data from 94 studies outlining the effectiveness and side effects of at least one urinary incontinence medication compared to a placebo. Drugs studied include darifenacin (Enablex), tolterodine (Detrol), trospium (Sanctura), fesoterodine (Toviaz), oxybutynin (Ditropan) and solifenacin (Vesicare). These drugs primarily work by improving bladder function and relieving bladder spasms.

Researchers defined effectiveness of the drug as reducing daily incidences of urinary incontinence by at least 50 percent. The study found that only 20 percent of women experienced this clinically significant marker, which suggests only moderate effectiveness. All of the drugs studied appeared to work equally well, which suggests there is not one that is better than the other.

Side Effects

Adverse side effects were frequently reported by the women in the studies and 50 percent of participants stopped using the drugs within one year of starting treatment due to negative effects. The most commonly reported side effect was dry mouth; others include constipation, upset stomach, dry eyes and dry skin. Participants using other medications at the same time were more likely to suffer from more serious side effects, such as an abnormal heart rhythm, or in some cases, death.

While all the drugs seemed to have a similar rate of effectiveness for reducing episodes of urinary incontinence, there were differences when it came to side effects. Researcher found oxybutynin had the highest discontinuation rate due to side effects while solifenacin had the lowest discontinuation rate. Long-term use of tolterodine in particular, was linked to an increased risk of hallucinations, something not reported with the other medications.

Bottom Line

The results of this study do not make any clear cut suggestions on use of these medications. While they suggest the overall effectiveness of these medications are moderate, they did work for some women and you may be in that 20 percent who achieve significant relief. Even if you do not meet that 50 percent marker or better, any improvement may be better than none. Not everyone experiences reported side effects from drugs, nor do people experience the same side effects or similar severity. Ultimately, you will need to gage how well they are working for you versus the severity of your side effects, should you be experiencing any.

Dietary and other Considerations

While drugs may be a possible tool, ideally lifestyle modifications should be your first line of defense. Changing your diet may be particularly helpful. Many women find certain foods and beverages aggravate their symptoms. Examples include alcohol, coffee, tea, citrus fruits and juices, tomatoes, chocolate and spicy foods. Individual responses to foods and beverages can vary and you should keep careful track of what you eat to help identify your personal triggers.

Bladder retraining can also be an effective tool, which involves training yourself to urinate at set times of the day. Kegel exercises may also be helpful. Squeezing and releasing this muscle -- which you can find by stopping your urine mid-stream -- can help strengthen muscles involved in the urination process. Your doctor can offer guidance on these techniques.

Because of the limited effectiveness and potential side effects, these medications may not be an option for you when it comes to managing urinary incontinence. You need to work with your doctor, who can give you comprehensive information on the potential benefits and drawbacks of these medications. This can help you make an informed decision about your treatment options.