Urinary incontinence — involuntary urine leakage — affects one in three women and many older men, and it is dramatically underreported and undertreated. It comes in several types: stress incontinence triggered by exertion, urgency incontinence from bladder overactivity, and mixed forms.
What's actually going on in research
Vibegron and mirabegron, beta-3 adrenergic agonists, offer overactive bladder treatment with fewer dry-mouth side effects than older medications. Sacral neuromodulation devices and posterior tibial nerve stimulation are being refined and compared in head-to-head trials. Pelvic floor muscle training delivered by physiotherapist, app, or biofeedback device remains the gold standard for stress incontinence, and trials are testing optimized delivery methods.
Beta-3 agonists
Drugs like vibegron relax the bladder muscle to reduce urgency and leakage with fewer side effects than anticholinergics. Trials are testing them in older adults and special populations.
Sacral neuromodulation
Implanted devices that modulate the sacral nerve controlling the bladder are being compared with medication and with less invasive posterior tibial nerve stimulation in larger trials.
Pelvic floor therapy optimization
Trials are comparing in-person pelvic floor physiotherapy, biofeedback-assisted home programs, and app-guided training for long-term improvement in stress incontinence.
What to know before you search
Eligibility depends on incontinence type (stress, urgency, mixed), episode frequency, prior pelvic surgery, hormonal status, and age.
What types of trials are currently open
- Drug trials — Testing new or improved bladder medications for urgency and mixed urinary incontinence.
- Device trials — Comparing sacral neuromodulation, tibial nerve stimulation, and pessary devices.
- Behavioral trials — Testing pelvic floor muscle training delivery formats, biofeedback, and bladder training programs.
- Surgical trials — Evaluating midurethral slings, urethral bulking agents, and autologous fascial slings.
- Observational studies — Tracking long-term outcomes and treatment persistence across therapies.
Recently added Urinary Incontinence trials
Effects of Action Observation and Metaphorical Imagery in Pelvic Floor Muscle Training for Geriatric Urinary Incontinence
This clinical trial investigates the effects of a 12-week Pelvic Floor Muscle Training (PFMT) program applied via Action Observation Therapy (AOT) with metaphorical imagery on urinary incontinence, quality of life, and treatment adherence in geriatric women. The study will be conducted between June 2025 and June 2026 in nursing homes in Istanbul, targeting women aged 65 and older who are diagnosed with stress or stress-predominant mixed urinary incontinence, possess normal cognitive function (Standardized Mini Mental Test score ≥ 24), and walk independently. Eligible participants will be divided into groups, where both will undergo a progressive exercise regimen involving twice-weekly 45-50 minute group sessions that advance from supine positions to standing and jumping movements. However, the AOT study group will uniquely perform these exercises while observing and imagining projected metaphor-themed visuals to enhance motor learning and motivation. Efficacy will be evaluated pre- and post-intervention using various standardized tools, including the Pelvic Floor Distress Inventory-20, a 24-hour pad test, the Incontinence Severity Index, the Movement Imagery Questionnaire-3, and the Incontinence Quality of Life Scale, to comprehensively assess improvements in incontinence severity, functional status, and overall well-being.
Impact of CMG vs VCMG in Recurrent Stress Incontinence- A Pilot Study
To asses feasibility of a prospective randomised trial comparing the outcomes of surgery for recurrent urinary incontinence after video-urodynamic(VCMG)and urodynamic(UDS)investigations. One of the greatest challenges for clinicians is the lack of correlation between bothersome urinary symptoms and the underlying urinary tract dysfunction. This has led to the development of several investigations aimed at improving diagnostic accuracy, with UDS and VUDS being the most noteworthy. Despite the heavy reliance on these invasive tests by clinicians, their indications and efficacy remain controversial and supporting literature data is scarce and nonvalidated. The investigators will perform a prospective randomised study of 30 women referred to our tertiary urological services at University College London Hospitals (UCLH) for treatment of recurrent stress urinary incontinence. The women will be investigated with either UDS or VUDS prior to receiving medical and surgical treatment tailored to the identified underlying urinary tract dysfunction. Adult women with symptoms suggestive of recurrent stress urinary incontinence after failed continence surgery will be included. Women who are pregnant, unfit for surgery, have a background of pelvic radiotherapy or relevant neurogenic disease that would put them at risk of neurogenic bladder will be excluded. UDS/VUDS will be performed under the care of Functional, Reconstructive and Adolescent Urology (FFA) Urology Service at UCLH adhering to standardised protocols. Treatment will be provided by FRA Team at UCLH. The primary outcome is assessment of symptoms of urinary incontinence by using validated questionnaires. Results will be correlated with patient characteristics, X-ray exposure, patient experience metrics, outcome and expenses to determine in which sub-populations performing UDS or VUDS has a higher impact on outcomes and when they should be avoided.
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