Use of weak opioids and mixed opioid agonists/antagonists for treatment of urinary incontinence

#The invention relates to the use of weak opioids and mixed opioid agonists/antagonists for the preparation of a medicament for the treatment of an increased urge to urinate or urinary incontinence, and to corresponding medicaments and methods for treatment of an increased urge to urinate or urinary incontinence.

#Urinary incontinence is the involuntary discharge of urine. This occurs in an uncontrolled manner when the pressure within the urinary bladder exceeds the pressure needed to close the ureter. Causes can be on the one hand an increased internal pressure in the bladder (e.g. due to detrusor instability) with the consequence of urgency incontinence and on the other hand a reduced sphincter pressure (e.g. following giving birth or surgical interventions) with the consequence of stress incontinence. The detrusor is the coarsely bundled multilayered bladder wall musculature, contraction of which leads to discharge of urine, and the sphincter is the closing muscle of the urethra. Mixed forms of these types of incontinence and so-called overflow incontinence (e.g. in cases of benign prostate hyperplasia) or reflex incontinence (e.g. following damage to the spinal cord) occur. Further details in this respect are to be found in Chutka, D. S. and Takahashi, P. Y., 1998, drugs 560: 587–595.

#The urge to urinate is the state, aimed at discharge of urine (miction), of increased bladder muscle tension as the bladder capacity is approached (or exceeded). This tensioning acts here as a stimulus to miction. An increased urge to urinate is understood here as meaning in particular the occurrence of a premature or increased and sometimes even painful urge to urinate up to so-called strangury. This consequently leads to significantly more frequent miction. Causes can be, inter alia, inflammations of the urinary bladder and neurogenic bladder disorders, and bladder tuberculosis. However, all causes have not yet been clarified.

#The object of the present invention was therefore to discover substances which are helpful for treatment of an increased urge to urinate or urinary incontinence and at active doses preferably simultaneously show fewer side effects and/or analgesic actions.

#Surprisingly, it has now been found that certain weak opioids and mixed opioid agonists/antagonists have an outstanding action on bladder function at low concentrations and accordingly are particularly suitable for treatment of corresponding diseases.

#The invention accordingly provides the use of one of the following compounds codeine or dihydrocodeine, dextropropoxyphene, meptazinol or tilidine as free base and/or in the form of physiologically acceptable salts for the preparation of a medicament for treatment of an increased urge to urinate or urinary incontinence.