Combined Medical and Behavioral Therapy for Urge Urinary Incontinence in Women

Urge incontinence (involuntary urine loss associated with a strong urge to void) in women is a common and vexing condition. Antimuscarinic agents such as tolterodine commonly are used to treat patients with this condition. In a multicenter, partially manufacturer-sponsored, U.S. trial, community-dwelling women (mean age, 57; two thirds postmenopausal) with urge-predominant urinary incontinence were randomized to 10 weeks of extended-release tolterodine (4 mg daily) plus behavioral training or to tolterodine alone. Behavioral training — provided by a nurse practitioner, nurse specialist, or physical therapist — included exercises for pelvic-floor muscle control and behavioral strategies to reduce urgency, bladder contractions, and stress. Ou…