Behavioral interventions have been used for decades to treat urge incontinence 
and other symptoms of overactive bladder. Perhaps the earliest form of treatment 
was the bladder drill, an intensive intervention designed to increase the 
interval between voids to establish a normal frequency of urination and 
normalization of bladder function. Bladder training is a modification of bladder 
drill that is conducted more gradually on an outpatient basis and has resulted 
in significant reduction of incontinence in older, community-dwelling women. 
Multicomponent behavioral training is another form of behavioral treatment that 
includes pelvic floor muscle training and exercise. This intervention focuses 
less on voiding habits and more on altering the physiologic responses of the 
bladder and pelvic floor muscles. Using biofeedback or other teaching methods, 
patients learn strategies to inhibit bladder contraction using pelvic floor 
muscle contraction and other urge suppression strategies. Although behavioral 
and drug therapies are known to be highly effective for reducing urge 
incontinence, few patients are cured with either treatment alone. Thus, future 
research should explore ways to enhance the effectiveness of these conservative 
therapies. Although the mechanisms by which behavioral treatments work have not 
been established, there is some evidence that behavioral and drug interventions 
may operate by different mechanisms, suggesting that they may have additive 
effects and that combining them may result in better outcomes. Future research 
needs to examine the mechanisms by which these therapies reduce incontinence and 
whether combining behavioral and drug treatment will result in better outcomes 
than either therapy alone.