Medical treatment of female urge incontinence

Urge incontinence is a common symptom in women. The etiology is multifactorial. In most patients, however, the underlying cause remains unclear. Symptomatic treatment with detrusor inhibiting drugs constitutes the mainstay of therapy in these idiopathic cases. Many drugs have been proposed although the documentary proof of their efficacy varies. Limited efficacy and systemic side effects are frequent problems using available drugs. Rational pharmacotherapy requires an up to date knowledge of the physiology, pathophysiology and the clinical pharmacology of the lower urinary tract. The principles of drug therapy should be based on: 1) meticulous assessment of the patient; 2) precise classification of the bladder dysfunction; 3) individual drug selection and dose adjustment; and 4) current control with critical assessment of the indications for continued therapy.