What is stress incontinence in neurologic disease?

Updated: Dec 27, 2018
  • Author: Frances M Dyro, MD; Chief Editor: Robert A Egan, MD  more...
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Answer

Answer

Stress incontinence occurs when intra-abdominal pressure exceeds resistance at the bladder neck. Medical management is focused on increasing pelvic floor function. Estrogen replacement helps restore mucosal function, which in the female plays a large role in maintaining intraurethral pressure.

Drugs that increase outflow resistance include alpha-agonists. Ephedrine and phenylpropanolamine have been used, but their adverse effects, such as palpitations, headache, and tremor, can be troublesome. Imipramine (and other tricyclic antidepressants) decrease bladder activity but also increase outflow resistance.


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