The history of the pharmacologic treatment of urgency incontinence

Today urgency, according to the International Continence Society, is defined as “the complaint of a sudden compelling desire to pass urine, which is difficult to defer”. The overactive bladder (OAB) is a symptom syndrome defined as the presence urgency with or without urgency incontinence accompanied by frequency and nocturia in the absence of infection or any other obvious aetiology. Treatment is primarily behavioural regulation with reduction in fluid intake, timed voiding, bladder training and pelvic floor muscle training. Pharmacologic treatment of urgency and urgency incontinence is oral medical treatment, e.g. anticholinergics or beta-3 agonists. In resistant cases, the patient will be offered treatment with injection of botulinum toxin A in the submucosa of the bladder. In ancient time, concise definitions were lacking and reports on treatment of urinary incontinence are therefore often a mismatch between treatment modalities of different types of urinary incontinence. This non-systematic review outlines the history of how urinary incontinence were evaluated in western medicine, emphasizing the pharmacologic treatment of urgency incontinence.