Urinary incontinence is a common and often embarrassing problem for older adults. There are many ways to treat urinary incontinence and urine leakage problems, including bladder training, exercises, medication, and surgery. Due to the sensitive nature of this medical issue, your patients may need your encouragement when discussing treatment options for the management of urinary incontinence. The following treatment options are recommended for improving bladder control in older adults:¹ First-line: Non-drug measures are the first-line recommended treatments for mild symptoms (e.g., timed voids, bladder training, fluid management). Second-line: If treatment goals are not met, oral anti-muscarinics are recommended unless contraindicated (e.g., narrow-angle glaucoma, impaired gastric emptying, or a history of urinary retention). Dose modification or trial of a different anti-muscarinic medication may be warranted if a patient experiences inadequate symptom control and/or unacceptable adverse drug events. Third-line: Surgery is a third-line recommended treatment option for carefully selected patients who have severe refractory symptoms. By encouraging your patients to discuss their options, they can receive the treatment they may need but have been reluctant to seek. Note: Most anti-muscarinics are available on the AmeriHealth drug formulary at the lowest level of cost-sharing.

¹American Urological Association guidelines