* Urinary Urge Incontinence (UUI) is the involuntary urine loss associated with a strong sensation to void. * UUI usually associated with reduced bladder capacity. * The pathophysiology is unclear. * Pelvic floor muscle dysfunction and detrusor instability have been suggested as possible mechanisms. * Standard treatment includes anticholinergic medication and behavior modification. * The study aims to compare the long term effectiveness of 4 different approaches to the treatment of women with Urge Urinary Incontinence (UUI): 1. Pelvic Floor Rehabilitation (includes muscle training+behavioral intervention+bladder training) 2. Pelvic Floor muscle training alone 3. Bladder Training alone 4. Drug treatment with Tolterodine. * Study variables will include: impairment ratings, quality of life, and cost-effectiveness. * This study addresses three issues: 1. The long term efficacy and cost-effectiveness of the various treatment options. 2. To identify the factors involved in determining the effectiveness of drug or behavioral therapy. 3. The pathophysiology of UUI. By subdividing the rehabilitation group into 3 arms, we hope to shed light on the mechanism of dysfunction. A better response in one group will help localize the problem to pelvic floor muscles or to detrusor instability.
Age range
45 Years – 75 Years
Sex
FEMALE
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A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
Number of micturitions in a 24 hour bladder diary and number of urge urinary incontinence episodes by subjects' reports per week.
Timeframe: Phase I, II, and III