Medications for Male Urinary Dysfunction

Your NYU Langone doctor may recommend medication to help ease the symptoms of male urinary dysfunction, including symptoms caused by benign prostatic hyperplasia, neurogenic voiding dysfunction, or stress and urgency incontinence.

Alpha Blockers

Taken by mouth, alpha blockers can relax the muscles of the prostate and the bladder neck, the area where the bladder meets the urethra, allowing urine to flow more easily. Alpha blockers can help ease the symptoms of benign prostatic hyperplasia. Side effects may include light-headedness or headache. 

NYU Langone urologists pioneered the use of these medications in the 1990s. 

Antimuscarinics

A type of anticholinergic medication, antimuscarinics relax the bladder by blocking nerves that control the contractions of the bladder wall’s detrusor muscle, which releases urine. 

Taken by mouth, anticholinergics help control symptoms of increased urinary frequency and urgency incontinence. Possible side effects include constipation and dryness of the mouth, nose, or throat.

5-Alpha Reductase Inhibitors

If you have a significantly enlarged prostate gland, 5-alpha reductase inhibitors can help to shrink it, decrease the urge to urinate, improve urine flow, lessen the sensation that the bladder isn’t completely emptied after urination, and reduce straining. This type of medication decreases certain male hormones, known as androgens, and helps shrink an enlarged prostate. 

It can take three to six months before you notice any benefit. Side effects may include decreased sex drive, mild breast enlargement or soreness, and erectile dysfunction.

Beta-3 Agonists

Taken by mouth, beta-3 agonists relax the bladder and reduce the involuntary contractions that can cause increased frequency of urination and urgency incontinence. These medications stimulate nerves that relax the bladder, allowing it to store more urine before your body releases it. They can raise blood pressure, so your doctor may check your blood pressure before starting this medication. 

NYU Langone urologists pioneered the use of these medications for overactive bladder.

Botulinum Toxin Injections

If other medications don’t work or cause side effects, your doctor may prescribe Botox®—a medication made from a chemical produced by the Clostridium botulinum bacterium—for urgency incontinence or neurogenic voiding dysfunction. Botox® works by relaxing or calming the bladder muscle. 

During the treatment, the urologist inserts a cystoscope, a thin, lighted instrument, into the bladder through the urethra to inject the medication into the bladder wall. The procedure is performed using local or general anesthesia. 

The benefits can last for up to a year, but injections may need to be repeated every few months, as the effects of this medication are designed to wear off. 

Botox® can cause you to retain urine, which can lead to infection. Your doctor may prescribe antibiotics for several days prior to the procedure to help prevent urinary tract infection. 

Phosphodiesterase-5 Inhibitors

Designed to treat erectile dysfunction, a phosphodiesterase-5 inhibitor may help reduce the symptoms of benign prostatic hyperplasia, though doctors aren’t certain precisely how these work. 

Your doctor may prescribe a low, daily dose of the medication, which is taken by mouth. The medication can have serious side effects, including a severe drop in blood pressure if it is taken with nitrate medications for heart disease. 

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