Once the cause of the urinary incontinence is determined, the clinician can now recommend several treatment options to the patient. It is important to note that there is no guarantee that a prescribed treatment will work and that a treatment’s efficacy will depend on the type and severity of the condition. The UK National Institute of Diabetes and Digestive and Kidney Diseases lists the following options:
● Behavioral interventions. Without taking medicines or using medical contraptions, this type of treatment focuses on changing habits, lifestyles, or behaviors that may trigger or contribute to the incontinence. Kegel exercises, which are performed by flexing the pubococcygeus (PC) muscles that are involved in the discharge of both urine and semen, are believed to help restore one’s control over urination. Modifying behaviors that contribute to loss of bladder control, such as smoking and taking too much alcohol, and avoiding food that can lead to obesity and diabetes also reduce a man’s risk of having bladder problems.
● Medicines. Certain classes of drugs may be prescribed by doctors to address specific (suspected) causes of UI, whether these maybe neural or prostatic in nature. These include:
1. Alpha blockers. This class of medicines treats problems caused by prostate enlargement and bladder obstruction by relaxing the smooth muscles of the prostate and bladder, and preventing abnormal contractions that can cause one to urinate involuntarily. These include terazosin, doxazosin, tamsulosin, and alfzosin.
2. 5-alpha reductase inhibitors. These inhibit the production of the hormone DHT which is believed to cause prostate enlargement. These include finasteride and dutasteride.
3. Imipramine. An antidepressant, it relaxes muscles and blocks neural signals that may cause abnormal bladder contractions.
4. Antispasmodics. These drugs work by relaxing the bladder muscle and relieving spasms. They include propantheline, tolterodine, oxybutynin, darifenacin, trospium chloride, and solifenacin succinate.