Urinary incontinence is the involuntary loss of urine. It is frequent, especially in children, women and the elderly.

Whatever the cause(s), urinary incontinence can have a huge psychological impact. As well as leading to skin irritation, it complicates patient care, exposing sufferers to falls.

There are numerous causes: organ related (damaged urinary tract), physical (increase in the volume of urine), neuropsychological (difficulty in reacting or going to the toilet), and sometimes toxic or drug-related. These causes are often interlinked.

A large number of drugs which affect the nervous system, mental capacity, muscle tone, urine volume, expose patients to urinary incontinence. These include sedatives, neuroleptics, benign prostatic hyperplasia treatments, some antihypertensive drugs and vasodilators, medication used to treat Alzheimer’s disease, hormone replacement therapy, etc. Furthermore, they are often prescribed for patients already prone to incontinence, especially elderly people presenting a number of illnesses and/or taking multiple treatments. The risk of urinary incontinence should be taken into account when prescribing these treatments.

Likewise, considering the possibility of urinary incontinence being drug-related makes it possible to reduce the dosage or even to halt the treatment.

©Prescrire 1 July 2015

"Drug-induced urinary incontinence" Prescrire Int 2015; 24 (162): 180-182. (Pdf, subscribers only).