Overflow urinary incontinence due to carbamazepine

Area of Science:

• Neurology
• Urology

Background:

• Temporal lobe epilepsy management often involves anticonvulsant medications.
• Urinary incontinence is a potential, though less common, adverse effect of some anticonvulsants.

Observation:

• A case study details a patient experiencing severe urinary incontinence during long-term carbamazepine therapy for temporal lobe seizures.
• Carbamazepine led to a significant increase in bladder capacity (1,700 ml) and symptoms of urgency and frequency.

Findings:

• Discontinuation of carbamazepine and initiation of primidone treatment resolved the urinary voiding symptoms.
• Post-voiding catheterization revealed minimal residual urine volume after symptom resolution.

Implications:

• This case highlights carbamazepine as a potential cause of overflow urinary incontinence.
• A review suggests primidone and phenobarbital may have fewer urological adverse effects compared to carbamazepine, phenytoin, and clonazepam.