Doctors commonly prescribe Vesicare, a commercial form of the medication solifenacin, to treat the symptoms of overactive bladder, or urge incontinence. It belongs to a class of drugs called anticholinergics, which work by relaxing smooth muscle tissue. Individuals who cannot take Vesicare may choose from several drug and non-drug alternative treatments.
If you cannot use solifenacin but can tolerate other anticholinergics, your doctor may prescribe any one of several medications. According to the U.S. National Library of Medicine, potential alternatives include tolterodine (Detrol), darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol) and trospium (Sanctura). Your doctor can help you determine which of these medications may work best for you. You may need to avoid all anticholinergics if pregnant, or if you suffer from narrow-angle glaucoma, as well as a number of kidney, stomach, urinary or liver disorders.
Your doctor may also prescribe tricyclic antidepressant medications, which inactivate your smooth bladder muscles in addition to their antidepressant effects. Potential alternatives include imipramine (Tofranil) and doxepin (Adapin, Sinequan). Additionally, if you are female, your doctor may prescribe low-dose topical estrogen to strengthen tissue in the areas surrounding your urethra and vagina. Treatment may come in the form of cream, a patch or a vaginal ring.
Look for several non-drug alternatives to treat your overactive bladder. Engage in bladder retraining, a technique designed to refamiliarize you with the physical details of filling and emptying your bladder. In addition to gaining awareness of the daily patterns of your incontinence, learn to empty your bladder only at certain scheduled times, and consciously avoid urinating outside of this schedule.
Help curb your incontinence by strengthening the muscles of your pelvic floor, which help control the flow of urine. Use a certain set of internal movements, called Kegel exercises, for this purpose. Consult your doctor to learn the details of these exercises, and to establish an appropriate exercise program.
Your doctor may use biofeedback and electrical stimulation used in combination with both bladder retraining and Kegel exercises. In biofeedback, your doctor will place a special sensor in your vagina or anus and use its output to measure the strength of your muscle contractions on a monitor. You will have the ability to view this monitor, and you can use it to learn when you properly contract and relaxing the muscles of your pelvic floor. In electrical stimulation, your doctor may use an anal or vaginal probe to send low-voltage electrical current to your pelvic floor muscles and encourage them to perform proper action.
If you have severe bladder symptoms or an unstable bladder, your doctor may consider you a candidate for a surgical procedure called augmentation cystoplasty, which involves adding a segment of your bowel to your bladder in order to increase your bladder's size and storage capacity. Consult your doctor or surgeon to learn the details of this procedure, as well as other potential alternatives to Vesicare use.