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Medical and minimally invasive treatment of urinary incontinence.

Authors
  • Lavelle, J P
  • Teahan, S
  • Kim, D Y
  • Chancellor, M B
Type
Published Article
Journal
Reviews in urology
Publication Date
Jan 01, 1999
Volume
1
Issue
2
Pages
111–119
Identifiers
PMID: 16985783
Source
Medline
License
Unknown

Abstract

Newer agents and procedures give urologists more options in treating patients who have urinary incontinence related to such etiologies as an ineffective sphincter, detrusor hypersensitivity, obstruction, or a combination of these. Abolition of the involuntary contractions characteristic of detrusor instability can be accomplished pharmacologically or surgically. First-line anticholinergic agents are tolterodine and oxybutynin XL, given orally. Alternatively, intravesical administration provides a high concentration of drug, such as capsaicin or resiniferatoxin, at the detrusor muscle level. However, this commits the patient to intermittent self-catheterization. Surgery is reserved for those who have failed prolonged trials of conservative therapies. For patients with intractable urge incontinence, urologists have the new technique of sacral nerve stimulation.

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