Urinary incontinence: Choices in medical therapy for overactive bladder

Urge incontinence, also described as overactive bladder (OAB)-wet, affects millions of persons worldwide. The traditional therapy for this disease has been medical management, although refractory cases may be addressed with neuromodulation and augmentation cystoplasty. Recent advances in medical therapy include selective antimuscarinic agents that potentially decrease adverse effects and off-label botulinum toxin injection of the bladder. Nonsurgical modalities, including behavioral modification, pelvic floor muscle training, and biofeedback with or without electrical stimulation, can be used in conjunction with medication to optimize outcomes.