Leonard S. Marks, M.D.

4th Quarter, 1999 -November has been declared "Incontinence Awareness Month," and perhaps no other non-fatal condition is so deserving of such a designation. Incontinence (involuntary loss of urine) is common: an estimated 17 milliion Americans, the majority women, experience it; incontinence is expensive, the annual U.S. pricetag approaching $20 billion; and for the afflicted individual, incontinence can be socially devastating.

Incontinence has always been a taboo subject. However, celebrity spokespeople such as Stefanie Powers have begun to make a real difference. Equally important is the fact that effective non-surgical treatments are now available. In the past year, two important medications---Detrol (tolterodine) and Ditropan XL (sustained release oxybutynin) ---have been approved for the treatment of urinary incontinence by the FDA. Both products seem effective in clinical practice, and each was the subject of a positive scientific study presented at the 1999 Annual Meeting of the American Urological Association (Detrol abstract; Ditropan XL abstract)

The U.S. FDA package insert for the two medications are available online: Detrol (tolterodine) and Ditropan XL (sustained release oxybutynin) (requires Adobe Acrobat reader)

Both Detrol and Ditropan XL are primarily used to treat a condition known as "Overactive Bladder" or urge incontinence. A description of the major types of incontinence is available online from the U.S. Public Health Service. An excellent way for an incontinent person to begin taking charge of the condition would be to keep a voiding diary,such as this one which is sanctioned by the National Institutes of Health.

Additional non-surgical treatments may include biofeedback and a variety of behavioral modification techniques. Other measures and supportive devices are described elsewhere.

USRF is currently enrolling post-menopausal women with urge incontinence in a clinical trial of a third medication (a Merck product), which promises to offer additional benefit. Interested women may contact the USRF offices for more information (310-838-6347).