Treatment of Huntington's Disease with Urinary Incontinence (Overactive Bladder with Urge Incontinence)

This protocol covers the management of urinary incontinence in patients with Huntington's disease, specifically those presenting with an overactive bladder pattern involving urge incontinence and/or sudden, unannounced urination.

Clinical Comorbidity

Urinary incontinence in Huntington's disease may be multifunctional or linked to deterioration of frontal lobe control centres, causing an overactive bladder with urge incontinence and/or unannounced urination. Accurate characterisation of the specific incontinence pattern is essential before selecting a management approach.

Treatment Approach (partial overview)

Management differs depending on whether the predominant presentation is sudden, complete bladder emptying or leakage associated with urge. A pharmacological approach is used, with each pattern addressed by a distinct type of agent. Careful monitoring for side effects — particularly effects on cognition — is integral to safe management in this population. The complete protocol, including agent selection and monitoring guidance, is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.3389/fneur.2019.00710

Urinary incontinence may either be multifunctional or linked to a deterioration of the frontal lobe control centers, causing an overactive bladder with urge incontinence and/or unannounced urination.

It is useful to investigate the presence of diurnal unexpected complete urination (complete and sudden bladder emptying, without urge) for which carbamazepine may be of benefit (Grade C).

In the case of an overactive bladder with leakage and urge incontinence, therapy with selective antimuscarinic may be tried, whilst watching out for the appearance of potential side effects, in particular confusional state.

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