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Anticholinergics block nerves that control the bladder’s muscle contractions, which cause urine to be released. Taken by mouth or worn in a skin patch, they may reduce leakage and the number of times per day you need to urinate. 

Side effects may include constipation and dryness of the mouth, nose, throat, or skin.

Beta-3 agonists, which are taken by mouth, reduce involuntary bladder contractions associated with urgency incontinence by relaxing the bladder muscle. 

Beta-3 agonists allow the bladder to store more urine before releasing it. They do not cause constipation and diarrhea, side effects sometimes brought on by anticholinergic medications. 

If other medications don’t stop your leakage or if you can’t tolerate the side effects, your doctor may prescribe Botox^®, a medication made from the Clostridium botulinum bacterium. 

This treatment is performed with a cystoscope, a thin, lighted instrument that’s inserted into the bladder through the urethra. Your doctor injects Botox^® into the bladder wall with a small needle from the cystoscope to calm the muscles that can cause urgency incontinence. 

This procedure is typically performed with local anesthesia in short sessions at the doctor’s office. Botox^® treatments are usually repeated at six-month intervals, but time between treatments may be longer for some women. The results can last up to 9 to 12 months.

Your doctor may prescribe antibiotics for several days prior to the procedure to help prevent a urinary tract infection. After the injection, your doctor monitors you to make sure that your bladder has been emptied before you leave the office.