Urinary incontinence: newer pharmacotherapeutic trends

Urinary incontinence is an under-reported epidemic with profound effects on quality of life. With recent pharmacologic advances, the belief that incontinence is an inevitable part of aging should be abandoned. Because many patients are unaware of curative options, they fail to report their symptoms and increase their risk of developing associated comorbid disease. Failure to diagnose and treat this disease in a timely manner increases society's economic burden associated with incontinence. Pharmacologic treatment of urge incontinence previously had limited treatment success because efficacious drugs were poorly tolerated, resulting in low patient compliance. Tolerance continues to be improved due to innovative new drugs and alternative delivery systems. While previous pharmacologic management of mild stress incontinence consisted of off-label agents with limited effectiveness, newly introduced drug therapy adds a viable, nonsurgical option for women with stress incontinence. The goal of this review is to update the clinician on the efficacy and tolerability of established and investigational pharmacologic modalities of therapy.