A patient taking an alpha-adrenergic medication for the treatment of hypertension is having a problem with incontinence. What does the nurse tell the patient?
a) The medication has caused permanent damage to the bladder sphincter and will require surgical correction.
b) Relaxation of the supporting ligaments has occurred and the patient will need to perform pelvic floor exercises to strengthen them.
c) When the medication is discontinued or changed, the incontinence will resolve.
d) The patient will require a medication regimen to decrease the overactivity of the bladder.
Answer: c) When the medication is discontinued or changed, the incontinence will resolve.
Iatrogenic incontinence refers to the involuntary loss of urine due to extrinsic medical factors, predominantly medications. One such example is the use of alpha-adrenergic agents to decrease blood pressure. In some people with an intact urinary system, these agents adversely affect the alpha receptors responsible for bladder neck closing pressure; the bladder neck relaxes to the point of incontinence with a minimal increase in intra-abdominal pressure, thus mimicking stress incontinence. As soon as the medication is discontinued, the apparent incontinence resolves.
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