No one optimal medical therapy is available for neuro-urological symptoms. Medications are often used in combination (one drug or more) with other techniques, such as intermittent detrusor. Treatments are tailored to the patient.
Drugs for storage symptoms
Antimuscarinic drugs are used in neuro-urological patients:
- to treat overactive bladder (see also patient information on overactive bladder)
- to increase bladder capacity
- to reduce urinary incontinence caused by bladder overactivity
These medications have some side effects, such as dry mouth, that can be reduced by lowering the dose or by taking the drug a different way (for instance, through the skin).
Some antimuscarinic drugs are oxybutynin, trospium, tolterodine, propiverine, darifenacin, and solifenacin.
A new category of medications called beta-3 adrenergic receptor agonists was recently introduced. Their use in neuro-urological patients is currently being studied.
Drugs for voiding symptoms
Drugs called alpha blockers seem to improve urination and may reduce the risk of sudden high blood pressure (autonomic dysreflexia). Some alpha blockers are tamsulosin and naftopidil.
Drug therapy is not recommended if your bladder does not contract enough (underactive bladder) or if your sphincter is not strong enough (severe stress urinary incontinence).