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Drugs are particularly worth considering in the treatment of urge incontinence, but primary urinary bladder diseases (inflammation, tumors, obstructions, conditions secondary to radiotherapy, stones or foreign bodies) should be ruled out before treatment starts. Today, the most important drugs are anticholinergics, which lessen the imperative urge micturition by attenuating the over-activity of the bladder musculature (detrusor muscle relaxation). This also leads to an increase in the maximum bladder capacity and to a reduction in the frequency of micturition, which can make everyday life much easier for the persons affected. Often, toilet or micturition training is only possible once anticholinergics have been administered.
Drugs can also play a helpful, supportive role in female stress incontinence, for example, alongside pelvic floor exercises. Alpha-adrenergic drugs may also be given to increase urethral tone. However, oestrogens are particularly indicated in such cases to balance the oestrogen deficiency that occurs in the postmenopausal period and is often implicated in stress incontinence.
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