Stress incontinence, involuntary loss of urine during episodes of sudden increase in intra-abdominal pressure such as coughing, sneezing, bending or laughing, worsens with age and childbearing. As many as 30 percent of elderly women and 15 percent of elderly men suffer from urinary incontinence, the Merck Manual explains. Obesity also increases stress incontinence. Strengthening bladder and pelvic muscles with medications helps improve some cases of stress incontinence.
Anticholinergics
Several types of anticholinergics--medications that relax the detruser muscle in the bladder, allowing it to fill properly--help treat stress incontinence. Anticholinergics work by blocking the action of the chemical acetylcholine, which causes bladder contractions, MayoClinic.com explains. Oxybutynin, the most effective of the anticholinergic medications for stress incontinence, comes in short-acting and extended-release oral forms and transdermal forms. Tolterodine, darifenacin, trospium and solifenacin are other anticholinergics used. Tolterodine may cause fewer side effects than oxybutynin; doses of tolterodine must be lowered for people with severe kidney disease.
Side effects of dry mouth and constipation occur less frequently in extended release and transdermal forms of anticholinergics, the Merck Manual reports. Less frequent side effects include blurred vision, rapid heartbeat, urinary retention, memory problems or confusion.
Alpha Adrenergic Agonists
Phenylpropanolamine and pseudoephedrine, alpha adrenergic agonists commonly used in cold medications, increase strength in the sphincter, the circular muscle that surrounds the bladder. These medications can cause anxiety, sleep disturbances and urinary retention in men, according to the Merck Manual. Alpha adrenergic agonists should not be taken by people with heart problems, high blood pressure, diabetes, elevated intraocular pressure or men with benign prostatic hyperplasia.
Tricyclic Antidepressants
Tricyclic antidepressants, such as imipramine, treat both stress incontinence and urge incontinence by relaxing the bladder muscles and tightening the bladder neck muscles, MayoClinic.com explains. Side effects similar to anticholinergic medications, such as dry mouth, blurred vision and constipation, can occur. Rarely, cardiac symptoms such as irregular heartbeat, low blood pressure, dizziness or fainting can occur.
Estrogens
After menopause tissue and muscles in the bladder weaken, worsening stress incontinence. Topical estrogen may increase muscle tone, although scientific evidence is lacking, MayoClinic.com states. Oral estrogen may worsen rather than improve symptoms.
