Adverse drug reactions in the urinary tract

Drugs can cause adverse effects on the urinary tract by a local action, or as a result of systemic effects on the autonomic nervous system, or central nervous control of bladder emptying. Tiaprofenic acid and cyclophosphamide as its metabolite acrolein, for example, can cause haemorrhagic cystitis. Localised retroperitoneal fibrosis, from methysergide, for instance, can lead to hydronephrosis. Agents with anticholinergic actions, such as the tricyclic antidepressants, can result in urinary retention, whilst alpha-adrenoceptor antagonists may lead to stress incontinence in females.