Change	Predisposes to
Detrusor overactivity (about 20% of healthy, continent persons)	Frequency, urgency, nocturia, urinary incontinence
Benign prostatic hyperplasia	Outlet obstruction with frequency, urgency, nocturia, urge or overflow UI
More urine output later in the day	Nocturia
Atrophic vaginitis and urethritis	Decreased urethral mucosal seal, irritation, urge and stress UI
Increased PVR	Frequency, nocturia, UI
Decreased ability to postpone voiding	Frequency, urgency, nocturia, UI
Decreased total bladder capacity	Frequency, urgency, nocturia, UI
Decreased detrusor contractility	Decreased flow rate, elevated PVR, hesitancy

• Delirium or confusional state
• Infection, urinary (symptomatic)
• Atrophic urethritis or vaginitis
• Pharmaceuticals
  • Sedatives or hypnotics, especially long-acting agents
  • Loop diuretics
  • Anticholinergic agents (antipsychotic agents, antidepressants, antihistamines, antiparkinsonian agents, antiarrhythmics, antispasmodics, opiates, and antidiarrheal agents)
  • Alpha-adrenoceptor agonists and antagonists
  • Calcium-channel-entry blockers
  • Vincristine
• Psychologic disorder, especially depression
• Endocrine disorder (hypercalcemia or hyperglycemia)
• Restricted mobility
• Stool impaction

Type of Medication	Potential Effects on Continence
Diuretics	Polyuria, frequency, urgency
Anticholinergics	Urinary retention, overflow
Psychotropics
Antidepressants	Anticholinergic actions, sedation
Antipsychotics	Anticholinergic actions, sedation, rigidity, immobility
Sedatives/Hypnotics	Sedation, delirium, immobility, muscle relaxation
Narcotic analgesics	Urinary retention, fecal impaction, sedation, delirium
Alpha-adrenergic blockers	Urethral relaxation
Alpha-adrenergic agonists	Urinary retention
Beta-adrenergic agonists	Urinary retention
Calcium channel blockers	Urinary retention
Alcohol	Polyuria, frequency, urgency, sedation, delirium,immobility