Refractory Urge Incontinence in Women: a randomized placebo controlled trial of antibiotic therapy for cystitis erradication

Urge incontinence — when you feel a sudden, strong need to urinate and cannot always hold it — is a very distressing problem for many older women. This trial is for women whose urgency and leakage has not improved despite trying bladder training and at least two different bladder medications over two years. The study will test whether adding a 6-week course of antibiotics to a commonly used bladder medication (darifenacin) gives better long-term control than the medication alone with a placebo. You may be eligible if: - You are a woman aged 50 or older - Your main problem is urge incontinence - Urodynamic testing has confirmed your bladder is overactive - You have tried at least 2 anti-muscarinic medications over 2 years without enough improvement - You leak urine at least once every 3 days You may NOT be eligible if: - Your overactive bladder is caused by a neurological condition (e.g. multiple sclerosis, spinal cord injury) - You have significant difficulty emptying your bladder - You cannot complete questionnaires due to language difficulties or dementia - You have elevated creatinine or kidney failure - You are allergic to more than penicillin Talk to your doctor about whether this trial might be right for you.