QuestionSBA
QuestionChoice
Whilst this TCA has anti-muscarinic effects, it is not recommended by NICE to treat urge incontinence.
10035076
e
Prescribe imipramine
QuestionChoice
This is an appropriate medication to trial if bladder training exercises and lifestyle measures are ineffective.
10035073
b
Prescribe tolterodine
QuestionChoice
This is an appropriate medication to trial if bladder training exercises and lifestyle measures are ineffective.
10035074
c
Prescribe darifenacin
QuestionChoice
This history is suggestive of urge incontinence. The first line management of urge incontinence is bladder training exercises whilst avoiding alcohol and caffeine which have a diuretic effect.
10035072
a
Advise avoiding alcohol and caffeine and offer referral for bladder training exercises
QuestionChoice
This is the first line management of stress incontinence rather than urge incontinence. Given the patient denies leaking urine on straining, urge incontinence is more likely to be the diagnosis.
10035075
d
Advise avoiding alcohol and caffeine and offer referral for pelvic floor muscle training exercises
Concept
Chapter
2693
6127
Types of urinary incontinence
Topic
336
General Practice
19418
Urge incontinence management includes bladder training exercises and avoiding diuretics like alcohol and caffeine to reduce urgency symptoms.
A 63-year-old woman experiences sudden urgency when needing to go to the toilet.

She denies any leaking of urine on coughing, laughing or sneezing.

She has no dysuria or haematuria.

Given the likely diagnosis, what is the most appropriate first-line management?
a