Urge incontinence management includes which approach?

• A. Bladder training and antimuscarinic medications such as oxybutynin
• B. Pelvic floor exercises
• C. Surgical intervention
• D. Antibiotics

Answer: (A)

Urge incontinence stems from detrusor overactivity, where the bladder contracts suddenly and involuntarily, causing leakage. The most effective approach combines behavioral therapy with medication that dampens those contractions. Bladder training teaches the patient to resist the urge, gradually increasing the interval between voids and using scheduled voiding, which reduces urgency and leakage over time. Antimuscarinic drugs like oxybutynin block acetylcholine at the detrusor’s muscarinic receptors, decreasing involuntary contractions and increasing bladder capacity, which directly lowers urgency and leakage episodes. Together, this duo addresses both how the bladder behaves and how the person responds to urges. Pelvic floor exercises are more aimed at stress incontinence, surgical options are for refractory cases, and antibiotics are only relevant for infections, not urge incontinence.