Which medication is considered a first-line treatment for urinary incontinence in women?

• A. Oxybutynin
• B. Duloxetine
• C. Mirabegron
• D. Finasteride

Answer: (B)

Duloxetine is recognized as a first-line treatment for urinary incontinence in women, particularly for stress urinary incontinence. It works as a serotonin-norepinephrine reuptake inhibitor (SNRI) that enhances the action of the pelvic floor muscles and increases urethral sphincter tone. This makes it effective for managing stress incontinence, which can occur due to activities that put pressure on the bladder, like coughing, sneezing, or exercising.

The mechanism of action of duloxetine helps improve bladder control by modulating neurotransmitter levels that influence the muscles involved in urination, thus providing a pharmacological strategy to alleviate the symptoms of urinary incontinence. Given such efficacy, it is considered a preferred first-line option for this condition in women.

Other medications listed, such as oxybutynin and mirabegron, are also used in the treatment of urinary incontinence but generally target different types or causes, like overactive bladder. Finasteride is primarily indicated for benign prostatic hyperplasia and does not have a role in treating urinary incontinence in women.