First-line management of urge incontinence includes bladder retraining and what else?

• A. Fluid management and pelvic floor exercises
• B. Antimuscarinic drugs
• C. Surgical sacral nerve stimulation
• D. Diuretics

Answer: (A)

The main idea is behavioral therapy for urge incontinence, paired with strategies to reduce bladder overactivity. Bladder retraining works by gradually increasing the interval between urges and voids, helping the bladder learn to hold more urine and reducing the frequency of urgent voiding. Adding pelvic floor muscle exercises strengthens the muscles around the urethra, improving control over leakage during urges. Fluids management—adjusting when and how much you drink—prevents excessive urinary frequency and reduces bladder irritability. Together, these nonpharmacologic steps form the first-line approach and can substantially lessen symptoms without meds. If symptoms persist, medications that calm the bladder (antimuscarinics) are considered, while more invasive options likeSacral nerve stimulation are reserved for refractory cases, and diuretics would worsen urgency and leakage.