![]() Distention of the bladder excites afferent A-delta fibers (and C fibers, in a pathologic condition) that relay information to the pontine storage center in the brain. In healthy individuals, the urinary bladder senses the volume of urine by means of distention. 5-8 TABLE 1 describes the various types of incontinence in more detail, along with the usual approaches used in the management of each. Other guidelines identify functional incontinence as a fifth type. Types of IncontinenceĪccording to the clinical practice guidelines issued by the Agency for Health Care Policy and Research (now called Agency for Healthcare Research and Quality), there are four types of incontinence: stress, urge, mixed, and overflow. Urinary incontinence may be underreported, owing to the embarrassing nature of the condition. The rate of incontinence in black men is similar to that for black women, but in white and Mexican-American men, the rate is 2.5 times lower than in women of the same ethnicity. In men, the prevalence increases with age, from 11% in those aged 60 to 64 years to 31% in those aged ≥85 years. 3 In a similar study, the prevalence of weekly incontinence was highest among Hispanic women, followed by white, black, and Asian-American women. Furthermore, a higher prevalence has been noted in non-Hispanic white women (41%) compared with non-Hispanic black (20%) and Mexican-American women (36%). In women, the prevalence is about 12.5% in those aged 60 to 64 years and rises to about 20.9% in those aged ≥85 years. The prevalence of urinary incontinence increases with age, with an overall prevalence of 38% in women and 17% in men. This article discusses the different types of incontinence, their causes, and the possible mechanisms underlying incontinence resulting from medications. The drugs may cause stress incontinence, urge incontinence, or overflow incontinence. Furthermore, carcinogens or inflammatory agents in the urine are in close proximity to the epithelium for prolonged periods when they are stored in the bladder. 1 Since drugs are frequently metabolized and excreted in the urine, the lower urinary tract is particularly vulnerable to adverse effects. 1Ī number of medications have been proposed as possible causes of drug-induced urinary incontinence, including alpha 1-adrenoceptor antagonists, antipsychotics, benzodiazepines, antidepressants, and drugs used for hormone replacement therapy. A number of factors may be responsible, including disease and adverse effects of medical treatment. Disturbances of this storage function of the bladder lead to urinary incontinence. This means that the bladder must store urine for several hours, a feature that requires the musculature of the bladder-outflow tract to contract to generate resistance. ![]() In healthy humans, voiding occurs at intervals several times a day, even though the kidneys produce urine continuously. The pharmacist should consider urinary incontinence–inducing drugs when reviewing patient profiles. Pharmacologic agents including oral estrogens, alpha-blockers, sedative-hypnotics, antidepressants, antipsychotics, ACE inhibitors, loop diuretics, nonsteroidal anti-inflammatory drugs, and calcium channel blockers have been implicated to some degree in the onset or exacerbation of urinary incontinence. The Agency for Health Care Policy and Research identified four types of urinary incontinence: stress, urge, mixed, and overflow. ![]() ABSTRACT: Urinary incontinence affects both men and women, and especially the elderly. ![]()
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