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Optimizing Pharmacotherapy in Older Adults: Urinary Incontinence

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Optimizing Pharmacotherapy in Older Patients

Part of the book series: Practical Issues in Geriatrics ((PIG))

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The appropriate management of urinary incontinence requires a comprehensive geriatric assessment with a focused history and examination including a review of medications. Pharmacotherapy should ideally be considered following a trial of conservative management, and both these approaches are not mutually exclusive. Medications available mainly target urge incontinence/overactive bladder and to a lesser extent stress and mixed incontinence. Treatment must be tailored and monitored carefully with regular follow-up since adverse effects of treatment can be considerable. Unfortunately, evidence on the use of many of these therapeutic agents in the frail older patient is limited.

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  1. Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci. 2008;9:453–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Aharony L, De Cock J, Nuotio M, Pedone C, Vande Walle N, Velge A, Vella A, Verdejo BC. Consensus document on the management of urinary incontinence in older persons. Eur Geriatr Med. 2017;8:202–9.

    Article  Google Scholar 

  3. Nabi G, Cody JD, Ellis G, Hay-Smith J, Herbison GP. Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2006;4:CD003781.

    Google Scholar 

  4. Wang J, Zhou J, Cui Y, Li Y, Yuan H, Gao Z, Zhu Z, Wu J. Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder. Neurourol Urodyn. 2019;38:22–30.

    Article  PubMed  Google Scholar 

  5. Hsieh PF, Hung-Chieh C, Chao-Hsiang C, Chieh-Lung CE. Botulinum toxin A for the treatment of overactive bladder. Toxins. 2016;8:59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lucas MG, Bedretdinova D, Berghmans LC, Bosch JLHR, Burhard FC, Cruz F et al. Guidelines on urinary incontinence—partial update. 2015 European Association of Urology.

    Google Scholar 

  7. Mohee A, Khan A, Harris N, Eardley I. BJU Int. 2012;111:106–13.

    Article  PubMed  Google Scholar 

  8. Abreu-Mendes P, Silva J, Cruz F. Pharmacology of the lower urinary tract: update on LUTS treatment. Ther Adv Urol. 2020;12:1–16.

    Article  Google Scholar 

  9. Schuessler B. What do we know about Duloxetine’s mode of action? BJOG. 2006;113(Suppl 1):5–9.

    Article  CAS  PubMed  Google Scholar 

  10. Jinhang L, Yang L, Chunxiao P, Tana Y, Haichao Y, Han P. The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis. Int Urol Nephrol. 2013;45:679–86.

    Article  CAS  Google Scholar 

  11. Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis. Neurourol Urodyn. 2004;23:302–5.

    Article  PubMed  Google Scholar 

  12. Legendre G, Ringa V, Fauconnier A, Fritel X. Menopause, hormone treatment and urinary incontinence at mid-life. Maturitas. 2013;74:26–30.

    Article  CAS  PubMed  Google Scholar 

  13. Weber MA, Lim V, Oryszcyn J, te West N, Soujet J, Jeffrey S, Roovers JP, Moore KH. The effect of vaginal oestriol cream on subjective and objective symptoms of stress urinary incontinence and vaginal atrophy: an international multi-centre pilot study. Gynecol Obstet Invest. 2017;82:15–21.

    Article  CAS  PubMed  Google Scholar 

  14. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, Lepor H, McVary KT, Nyberg LM Jr, Clarke HS, Crawford ED, Diokno A. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003;349:2387–98.

    Article  CAS  PubMed  Google Scholar 

  15. Takahashi S, Kato K, Takei M, Yokoyama O, Gotoh M. Efficacy and safety of the noradrenaline reuptake inhibitor, TAS-303, in women with stress urinary incontinence: results of a double-blind, randomized, placebo-controlled, early phase II trial. Int J Urol. 2021;28(1):82–90.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Antoine Vella .

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Vella, A., Pedone, C. (2023). Optimizing Pharmacotherapy in Older Adults: Urinary Incontinence. In: Cherubini, A., Mangoni, A.A., O’Mahony, D., Petrovic, M. (eds) Optimizing Pharmacotherapy in Older Patients. Practical Issues in Geriatrics. Springer, Cham.

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28060-3

  • Online ISBN: 978-3-031-28061-0

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