A pharmacological paradigm for urinary incontinence and enuresis.

The qualitative aspects of drugs used in enuresis control or associated with enuresis or urinary incontinence and the pathological disorders associated with enuresis or urinary incontinence are reviewed. The literature to date does not clarify the factors that account for tricyclic antidepressant effectiveness in enuresis. However, it does reveal that enuresis and urinary incontinence are common symptoms of basal ganglion disorders. Furthermore, pharmacological agents that depress or block dopamine activity produce urinary incontinence or enuresis, while those drugs augmenting the noradrenergic system facilitate continence. It is postulated that urinary incontinence and enuresis are secondary to an imbalance of catecholamine neurotransmitters within basal ganglion structures. A hypothesis is proposed suggesting that dopamine agonists could be viable therapeutic alternatives to tricyclics in treating enuresis and urinary incontinence. Additional clinical drug trials are needed to assess the characteristic responses of specific catecholamine agents in urinary incontinence and enuresis.