1. Prescribing information is available at this meeting MODULE 3 TREATMENT OPTIONS AND EXPECTATIONS 1 DET 808

2. Prescribing information is available at this meeting Behaviour modification Physiotherapy/pelvic-floor muscle training Other nonpharmacological therapies Pharmacotherapy 12. Wein AJ, Rovner ES. Int J Fertil. 1999;44:56-66. 2 TREATMENT OPTIONS

3. Prescribing information is available at this meeting Bladder retraining 12 –Increase bladder capacity –Voiding diary Lifestyle changes 12 –Fluid management 12. Wein AJ, Rovner ES. Int J Fertil. 1999;44:56-66. 3 BEHAVIOUR MODIFICATION

4. Prescribing information is available at this meeting 4 Locate pelvic muscles Repeat in sets of up to 10 3 times/day Relax completely for at least 10 seconds Squeeze muscles tightly for up to 10 seconds 27. Kegel-exercises.com website. PHYSIOTHERAPY Pelvic floor (Kegel) exercises 27 Strengthen muscles that control micturition

5. Prescribing information is available at this meeting PHYSIOTHERAPY (CONTINUED) Electrostimulation 13 –Not standardised –Questionable improvement Pelvic cone 28 12. Wein AJ, Rovner ES. Int J Fertil. 1999;44:56-66. 28. Herbison P, et al. The Cochrane Database Syst Rev. 2002 (1):CD002114. 5

6. Prescribing information is available at this meeting OTHER NONPHARMACOLOGICAL THERAPIES Devices –Periurethral injection 12 –Incontinence ring pessary 29 Surgery –Augmentation cystoplasty 12 12. Wein AJ, Rovner ES. Int J Fertil. 1999;44:56-66. 29. Goldman L. OB/GYN News. March 1, 2002. 6

7. Prescribing information is available at this meeting PHARMACOLOGICAL THERAPY Antimuscarinics –Tolterodine 12 –Oxybutynin 12 –Trospium 12 –Solifenacin 30 Note: Pharmacological therapies listed may not be approved for use in all countries. 12. Wein AJ, Rovner ES. Int J Fertil. 1999;44:56-66. 30. Chilman-Blair K, Drugs Today (Barc) 2004;40(4):343-353. 7

8. Prescribing information is available at this meeting BALANCING EFFICACY AND TOLERABILITY EFFICACYTOLERABILITY RECEPTOR PROFILE Example:  Urge Urinary Incontinence Episodes  Frequency Effects on Other Organs BLADDER SELECTIVITY PK/PD 8

9. Prescribing information is available at this meeting MANAGING PATIENTS’ EXPECTATIONS

10. Prescribing information is available at this meeting SET REALISTIC GOALS AT THE START SHORT TERM Learn about the disorder and how to manage it MEDIUM TERM Improvements in symptoms Continued improvements in symptoms, note improvement in QoL LONG TERM Continued stability in symptom control and QoL 10

11. Prescribing information is available at this meeting EVALUATE PROGRESS Voiding diary Patient perception –Rate bladder problems (none, very minor, minor, moderate, severe, many severe) –Rate ability to finish tasks without leaking (usually, if go immediately afterward, usually not) –Reduction in symptoms so patients can get back to doing things they used to do 11