A 40-year-old otherwise healthy nulligravida woman presents with involuntary loss of urine that occurs after drinking a small amount of water, when washing the dishes, when hearing water running, and sometimes for no reason discernable to the patient. It is preceded by suddenly feeling the need to urinate, and it happens both during the day and at night. Urine analysis and culture, pelvic, gynecological, and neurological examinations are normal. Cystometric studies show residual volume of 45 mL (normal) with involuntary detrusor contractions, starting already with 200 mL.
What is the best treatment in this patient?
a. Pelvic floor muscle training
b. Bladder training and timed voiding
c. Anticholinergic medication
d. Botox injection into the bladder walls