Clinical Medicine Insights: Urology

Urinary incontinence in women is quite prevalent today and management can be costly. Urinary incontinence can be minimal or quite bothersome, limiting activities of daily living. It is subdivided into urgency urinary incontinence, stress urinary incontinence, and mixed urinary incontinence. As such, treatment can vary immensely depending on the clinical presentations, ranging from behavioral modification to medicinal therapies to surgical procedures. First-line management for all urinary incontinence includes lifestyle and behavioral modifications. Historically, treatment options for urgency urinary incontinence were predominantly antimuscarinics, while more recent therapies include oral beta-3 agonist administration, sacral neuromodulation, onabotulinumtoxinA injection, and posterior tibial nerve stimulation. Stress urinary incontinence can be treated with a variety of urethral bulking agent injections or sling-based procedures using mesh, autologous fascia, or cadaveric fascia, as well as urethral intrasphincteric injections of autologous muscle-derived cells in new clinical trials. These recent advances that have been developed to help better curb urinary incontinence are discussed in this review.