What is the first-line management for stress incontinence?

What is the first-line management for stress incontinence?

• A. Anticholinergic therapy
• B. Pelvic floor exercises; if insufficient, mid-urethral sling
• C. Urinary catheterization
• D. Pelvic radiotherapy

Answer: (B)

First-line management for stress incontinence focuses on strengthening the pelvic floor with targeted pelvic floor muscle training. This improves urethral support and the ability to maintain continence during increases in abdominal pressure, such as coughing or sneezing. If there isn’t enough improvement after a proper trial period, a mid-urethral sling is considered to provide durable urethral support. Anticholinergic therapy targets urge incontinence, not stress incontinence; catheterization is for acute retention or short-term bridging, and pelvic radiotherapy is not used to treat stress incontinence and can worsen pelvic function.

First-line management for stress incontinence focuses on strengthening the pelvic floor with targeted pelvic floor muscle training. This improves urethral support and the ability to maintain continence during increases in abdominal pressure, such as coughing or sneezing. If there isn’t enough improvement after a proper trial period, a mid-urethral sling is considered to provide durable urethral support. Anticholinergic therapy targets urge incontinence, not stress incontinence; catheterization is for acute retention or short-term bridging, and pelvic radiotherapy is not used to treat stress incontinence and can worsen pelvic function.