Urinary incontinence. Drug therapy in comorbid patients

he problem of urinary incontinence is interdisciplinary. Such patients are seen by therapists, general practitioners, pediatricians, urologists, gynecologists, and neurologists. It is also necessary to note the comorbidity of urinary incontinence with arterial hypertension, diabetes mellitus, and obesity. The most common types of urinary incontinence include urgent (called overactive bladder – OAB) and stress incontinence. The diagnosis of OAB is established based on a subjective assessment of symptoms (with at least 8 urinations and/or at least 2 episodes of urgent urinary incontinence per day) in the absence of signs of urinary tract infection, while urinary incontinence itself is not a mandatory symptom (2/3 of patients have "dry" OAB). If OAB is detected, treatment can be started immediately to eliminate frequent and urgent urination. If the treatment of stress urinary incontinence is focused on surgical correction methods, primarily sling operations, then in the treatment of urgent urinary incontinence, the main place is occupied by drug therapy, which can be prescribed by a physician of the therapeutic profile. The presented publication presents 4 clinical cases in which patients required a consultation with a urologist and additional examination for diagnosis and treatment. In all the presented clinical cases, conservative therapy with the M-anticholinergic trospium chloride was prescribed. The discussion analyzes the pharmacokinetics and pharmacodynamics of trospium chloride, which made it possible to highlight a number of its advantages over tertiary amines in the treatment of urinary incontinence and OAB.