Drug-induced Urinary Incontinence in Children: A Narrative Review

Abstract

Drug-induced urinary incontinence is often an underreported problem because of the considerable embarrassment experienced by both patients and caregivers, and because the benefits of the primary treatment often outweigh this side effect. The aim was to explore the available literature to identify drugs causing incontinence and enuresis as side effects in children. A PubMed search was performed for all years up to February 2024 using the following keywords and associated medical subject headings: Incontinence or Enuresis in combination with Antiepileptics or Antipsychotics. Studies in English with the above-mentioned keywords were included after data cleaning. The included studies comprised cohort studies, randomized controlled trials, cross-sectional studies, case reports, and descriptive studies. A total of 193 records were identified using a PubMed search from all years until February 2024. After data cleaning, 25 records were included, most of which were case reports. Antipsychotics, antidepressants, antiepileptics, and central nervous system stimulants were the drugs more commonly involved, while a few studies also mentioned antihistamines and chelating agents. The common mechanisms of action leading to incontinence were reduction of the bladder outlet resistance, an increase in intravesical pressure, overproduction of urine, or abnormalities in the central nervous system’s control of urination. Although numerous drug classes could theoretically cause urinary incontinence based on pathophysiological factors, there is little evidence linking drug use to incontinence due to a lack of literature supported by ample clinical trials, systematic reviews, and meta-analyses. Mostly, only anecdotal case reports were found in this context. Therefore, further studies are needed.