TypeConservative managementPharmacologicSurgical
Urge
  • Weight loss

    Fluid reduction

    Constipation management

    Bladder training

    Pelvic floor muscle exercises

    Electrical stimulation of the posterior tibial nerve

  • Anticholinergic drugs

    Beta-adrenergic agonists (mirabegron [Myrbetriq])

    OnabotulinumtoxinA (Botox)

    Intravaginal estrogen*

  • Neuromodulation (implanted sacral nerve stimulator)

Stress
  • Weight loss

    Smoking cessation

    Fluid reduction

    Constipation management

    Pelvic floor muscle exercises (alone or with manual or biofeedback)

    Extracorporeal magnetic innervation

    Electrical stimulation

    Mechanical devices (e.g., pessary, urethral plugs)

  • Alpha-adrenergic agonists (e.g., pseudoephedrine, phenylephrine)*

    Duloxetine (Cymbalta)*

Sling procedures
  • Suburethral sling with tension-free vaginal tape

    Pubovaginal sling

    Midurethral sling

Urethropexy
  • Needle urethropexy

    Retropubic urethropexy or colposuspension (i.e., Burch and Marshal-Marchetti-Krantz procedures)

Periurethral injections of bulking agents
Mixed
  • Combination of above treatments with focus on dominant symptoms

  • Medication focused on dominant symptoms

Overflow
  • Relief of obstruction

    Clean intermittent catheterization

    Indwelling urethral catheter

  • Alpha-adrenergic antagonists or blockers (e.g., tamsulosin [Flomax])

  • Suprapubic catheter