Conservative therapy of stress incontinence in women is not as effective as surgery but proved highly effective in indicated cases. Conservative therapy includes pelvic floor muscle training, pharmacotherapy ( α -sympatomimetics, duloxetine, tricyclic antidepressants, estrogens) and pessary therapy.
Pharmacotherapy is the method of choice in urge incontinence in contrast to stress incontinence. The therapy is based on anticholinergics that appear highly effective but, at the same time, have important adverse effects such as xerostomia, xerophtalmia, impaired accommodation and constipation which are the major reasons for therapy discontinuation.
In postmenopause this therapy also includes vaginal estrogens that allow reducing the dose of anticholinergics while maintaining high efficacy of the treatment. Although pharmacotherapy of urinary incontinence usually is not 100 % effective, it is helpful in improving considerably quality of life of affected women.