Incontinence and Medication

Since my radical robotic prostatectomy in April of 2018, I have had to deal with mild, and occasionally moderate, incontinence. Kegeling and work with a pelvic floor therapist helped, but I have not been able to regain full continence.

Around the house and doing light chores I don’t need protection, but when I leave the house or engage in light exercise I wear a lightweight shield. For heavier exercise, like a strenuous hike, I occasionally wear a maximum absorbency guard.

Dealing with depression

That was my pattern for over three years until just recently. In my lifetime I have experienced a few bouts of depression. On two occasions I was prescribed an anti-depressant and a sleep medication to deal with insomnia and anxiety. In both of those cases, the last of which was in 2004, I cycled off the medications in a relatively short period of time.

Recently, some life factors that were out of my control led to another experience with depression, somewhat more severe than in the past. I experienced significant anxiety, insomnia and weight loss. Each day was a struggle, especially after a long period of poor sleep. I finally consulted with my primary care physician and started weekly sessions with a therapist.

An unexpected side effect

Once again, medication was recommended, again with the goal of stabilizing my mood and sleep and eventually cycling off the medications. I started taking Lexapro for depression and Clonazepam for anxiety and insomnia, both once a day in relatively small amounts. Both my mood and my sleep have improved dramatically, and I experience little or no abnormal anxiety.

But one unexpected side effect has been an increase in incontinence. The long list of side effects listed with the drugs does not include anything related to incontinence, so I consulted with my doctor about what the cause might be. He suggested that the Clonazepam relaxes the muscles that surround the sphincter that controls urine flow and contributes to the additional incontinence.

Being mindful of incontinence

I am now engaged in cycling off of the Clonazepam, as of my writing this, and hope that I’ll see a return to my normal level of incontinence. Neither the normal pattern nor the current pattern dramatically affect my lifestyle, but I have to be far more mindful of the current situation in terms of being prepared for more release of urine, especially when I leave the house and spend a lot of time walking.

I’d be happy to hear from anyone who has experience with what I’ve covered in this article.