How they work
Anticholinergic drugs block the action of a chemical messenger acetylcholine so the bladder has less contractions.
Anticholinergic medications include:
- Oxybutynin (Ditropan XL, Oxytrol)
- Tolterodine (Detrol)
- Darifenacin (Enablex)
- Solifenacin (Vesicare)
- Fesoterodine (Toviaz)
Can treat mostly urge urinary incontinence and overactive bladder. Mirabegron relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It will also help to empty your bladder more completely because the bladder hold more urine.
Low-dose, topical estrogen in the form of a vaginal cream, that can rejuvenate deteriorating tissues in the vagina and urinary tract and relieve some incontinence symptoms.
Imipramine (Tofranil) is a tricyclic antidepressant. It makes the bladder muscle relax, while causing the smooth muscles at the bladder neck to contract. It may be used to treat mixed incontinence when there is both urge and stress incontinence.
Usually taken at night because it can cause drowsiness.
How it works
Duloxetine (Cymbalta) is a serotonin and norepinephrine reuptake inhibitor that is approved to treat depression. Studies suggest it might work for both urinary incontinence and depression.
The most effective treatment for male SUI is an artificial urinary sphincter device.
This device has three parts:
- A fluid-filled cuff (the artificial sphincter), surgically placed around your urethra.
- A fluid-filled, pressure-regulating balloon, inserted into your belly.
- A pump you control inserted into your scrotum.
The artificial urinary sphincter cuff is filled with fluid which keeps the urethra closed and prevents leaks. When you press on the pump, the fluid in the cuff is transferred to the balloon reservoir. This opens your urethra and you can urinate. Once urination is complete, the balloon reservoir automatically refills the urethral cuff in 1-3 minutes.
Artificial sphincter surgery can cure or greatly improve urinary control in more than 7 out of 10 men with SUI. Results may vary in men who have had radiation treatment. They also vary in men with other bladder conditions or who have scar tissue in the urethra.
Male Sling for SUI
The male sling is usually used for only mild SUI. It is less effective and not recommended in men who have had radiation therapy to the prostate, pelvis, rectum or urethra. The male sling is a narrow strap made of synthetic mesh placed under the urethra through small surgical incisions near the scrotum. The procedure is outpatients. Risks including injury to urethra, bladder, urinary retention, mesh erosion or infection.