Medication is used secondarily often as an adjunct to behavioral treatments. Surgical interventions are an option in properly selected patients especially those with stress incontinence.
Urge incontinence
First-line treatment: behavioral therapies such as bladder training and bladder drill second-line treatment:medications such as oxybutynin (Ditropan) or imipramine (Tofranil) third-line treatment:surgical procedures (rately used)
Stress incontinence
First-line treatment: behavioral therapies such as Kegel's exercise and bladder training second-line treatment: medications such as alpha-adrenergic drugs and/or estrogen Third-line treatment:surgical procedurest
Overflow incontinence
First-line treatment: intermittent catheterization
Second-line treatment:indwelling catheterization
Third-line treatment: suprapubic catheterization
Nonoverflow urinary incontinence (sometimes used)
Pessaries
Electric stimulation devices
Surgically implantable artificial sphincters
Periurethral bulking injections
Penile compression devices
Biofeedback
Vaginal cones
Lntraurethral inserts
Suggested first second-and third-line treatments may not be applicable in all patients.Clinical judgment along with a patient's medical condition, cognition and choice,should always be considered.