title: Pharmacologic treatment for urgency-predominant urinary incontinence in women diagnosed using a simplified algorithm: a randomized trial.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA, USA. ahuang@ucsfmed.org
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
authors.forename: Lily A
authors.initials: LA
authors.lastname: Arya
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Bradley
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Rogers
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Myers
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: W Thomas
authors.initials: WT
authors.lastname: Gregory
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Kraus
authors.forename: Michael
authors.initials: M
authors.lastname: Schembri
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000368:Aged; D000465:Algorithms; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D003661:Decision Support Techniques; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053202:Urinary Incontinence, Urge / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D018727:Muscarinic Antagonists; C526675:fesoterodine