Management of urinary incontinence in adults

Abstract

The two functions of the bladder are storing and voiding urine. Dysfunction of either can cause incontinence. Urgency incontinence is a storage dysfunction most often associated with detrusor overactivity. It can be managed by bladder training and antimuscarinic drugs. Stress incontinence is a storage dysfunction most often associated with poor ligamentous support of the pelvic floor or sphincter deficiency, or both. Drugs have a very limited role in treatment. Surgery is often needed. Voiding dysfunction can be caused by bladder outlet obstruction, such as benign prostatic hyperplasia. Drug treatment may include alpha blockers. Drugs for incontinence only have modest efficacy. They can have adverse effects away from the urinary tract, which may be particularly problematic in older people.