Pharmacologic treatment for urgency-predominant urinary incontinence in women diagnosed using a simplified algorithm: a randomized trial.

Academic Article

Abstract

  • OBJECTIVE: The purpose of this study was to evaluate clinical outcomes associated with the initiation of treatment for urgency-predominant incontinence in women diagnosed by a simple 3-item questionnaire. STUDY DESIGN: We conducted a multicenter, double-blinded, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence in ambulatory women diagnosed by the simple 3-item questionnaire. Participants (N = 645) were assigned randomly to fesoterodine therapy (4-8 mg daily) or placebo. Urinary incontinence was assessed with the use of voiding diaries; postvoid residual volume was measured after treatment. RESULTS: After 12 weeks, women who had been assigned randomly to fesoterodine therapy reported 0.9 fewer urgency and 1.0 fewer total incontinence episodes/day, compared with placebo (P ≤ .001). Four serious adverse events occurred in each group, none of which was related to treatment. No participant had postvoid residual volume of ≥ 250 mL after treatment. CONCLUSION: Among ambulatory women with urgency-predominant incontinence diagnosed with a simple 3-item questionnaire, pharmacologic therapy resulted in a moderate decrease in incontinence frequency without increasing significant urinary retention or serious adverse events, which provides support for a streamlined algorithm for diagnosis and treatment of female urgency-predominant incontinence.
  • Authors

    Keywords

  • Aged, Algorithms, Benzhydryl Compounds, Decision Support Techniques, Double-Blind Method, Female, Follow-Up Studies, Humans, Middle Aged, Muscarinic Antagonists, Surveys and Questionnaires, Treatment Outcome, Urinary Incontinence, Urge
  • Digital Object Identifier (doi)

    Authorlist

  • Huang AJ; Hess R; Arya LA; Richter HE; Subak LL; Bradley CS; Rogers RG; Myers DL; Johnson KC; Gregory WT
  • Start Page

  • 444.e1
  • End Page

  • 444.11
  • Volume

  • 206
  • Issue

  • 5