Detailed definition
Urge urinary incontinence (UUI) is the leakage component of overactive bladder syndrome (OAB), defined by urinary urgency (a sudden compelling need to void that is difficult to defer), usually with frequency and nocturia, with or without incontinence. The mechanism is involuntary detrusor contractions during the storage phase. Prevalence rises with age, and postmenopausal women are disproportionately affected. Workup includes voiding diary, ruling out infection, and considering pelvic exam for atrophy. Treatment is stepwise: behavioral therapy (timed voiding, bladder training, fluid management, caffeine reduction), pelvic floor exercises, vaginal estrogen for postmenopausal women (modest improvement in urgency symptoms and reduction in UTIs that worsen urgency), pharmacotherapy (anticholinergics like oxybutynin, tolterodine, solifenacin; or beta-3 agonists like mirabegron, vibegron), and for refractory cases percutaneous tibial nerve stimulation, sacral neuromodulation, or intradetrusor onabotulinumtoxinA injections.
Why it matters in menopause
Vaginal estrogen is one of the under-utilized first interventions for postmenopausal urge symptoms, often given alongside (or before) systemic anticholinergic medications, which carry cognitive side effects in older women. ClearedRx can prescribe vaginal estrogen as a stand-alone treatment for postmenopausal urgency and rUTI.
Related terms
Sources
External references: Wikipedia.