Urgency urinary incontinence pathophysiology is explained from a network of neurological concepts, with multiple triggering factors, which end up producing involuntary contractions of the detrusor muscle that generate urgency symptoms and subsequent incontinence [1].
Muscarinic receptors (M2 and M3) in bladder area are involved in promoting contraction through parasympathetic action, and β3 receptors convey sympathetic action, promoting muscle relaxation.
Therefore, two first-line routes of pharmacological treatment of urinary urgency are: anticholinergic drugs and β-adrenergic drugs. However, there is a lack of adherence to treatment with anticholinergic drugs in patients, and knowing the different factors that affect this continuity is one of the goals of studies on UUI in recent years [2,3]. 
Our objective is to know the use of drugs for urgency urinary incontinence in our area and proposing a collection of the reasons for 'NO CONTINUITY'.

Mixed quantitative-qualitative cross-sectional study. One part analyses the reasons for dropout qualitatively, and the other studies the parameters associated with dropouts in a quantitative, descriptive and relational way.
Our target population were women who present with urinary urgency with pure UUI in whom treatment with anticholinergic drugs is prescribed during the year 2023 in our centre. Only those patients who did not previously improve with non-pharmacological measures such as bladder re-education, attention to the intake of bladder stimulants and evaluation of diuretic administration are included.
Variables:
- Main: Abandonment of medication (yes/no), nª episodes, urination frequency, nocturia, ICQ-SF, perineal testing, concomitant prolapse, previous pelvic floor surgery, demographics (age, BMI, hormonal status, parity, diabetes), previous IUU treatment, description of the reason for abandonment.
To collect information, a specific Excel® type database was used that included the sociodemographic and clinical data of the patients obtained from the anamnesis and clinical history.
The results were analysed with the Stata 14.0 statistical analysis package:
-In the descriptive analysis, the categorical variables (absolute numbers and/or percentage) and the continuous variables were presented with the mean and standard deviation, if they follow the normal distribution; with median and percentiles if they do not follow this distribution.
-In the bivariate analysis of the data, the categorical variables were compared with the Chi square test (or Fisher's exact test when indicated) and the continuous variables, depending on the normality of the data, were analysed according to the Student's t test or with a McNemar test if non-parametric tests were not required.
- The multivariate analysis was not addressed, due to the only association of parameters in the bivariate, which did not allow combinations.
The introduction of cases maintained the confidentiality of data collected and identified only through coding, so no type of information that would allow the participants to be identified was included.
The treatment, communication and transfer of personal information obtained by written or digital means is protected by Organic Law 3/2018 of December 5, on data protection and guarantee of digital rights.

A total of 122 women who were prescribed treatments with anticholinergic drugs were included. The average age of our population was 67 years (minimum 38 - maximum 88 years). Body Mass Index (BMI) was 29.7 (minimum 19 – maximum 48) and the Oxford Test was 2 (minimum 0 – maximum 5). In 39 patients (32%), pelvic organ prolapse was associated, and 29 patients (23.8%) had a history of pelvic floor surgery. The average ICIQ-SF was 13 (minimum 0 – maximum 20).
The drugs prescribed in our sample were Fesoterodine in 73 patients (59.8%), Solifenacine in 43 patients (35.25%), Desfesoterodine in 3 patients (2.46%), Oxybutynin in 2 patients (1.64%) and Tolterodine in 1 patient (0.82%). Treatment was considered subjectively effective in 80 cases, according to the women's opinion (66.7%) and partially effective in 8 cases (6.67%).
Of the 122 women treated with anticholinergics, treatment abandonment was detected in 40 patients (32.8%). Of them, 22 patients (55%) abandoned treatment due to the appearance of adverse effects associated with the use of anticholinergics (dryness of the mucous membranes, cognitive impairment, epigastric pain, edema in the lower extremities), 14 patients (35%) due to lack of treatment effect and 4 patients (10%) for economic reasons (inability to afford it despite being financed by the National Health System).
In the comparative analysis, no relationship was observed between abandoning treatment and the type of anticholinergic drug used (Pearson chi2= 1.4870; Pr = 0.829), age (t-test=0.8281; Pr = 0.4093) or having diabetes mellitus (Pearson chi2 = 1.0026; Pr = 0.317), pelvic organ prolapse (Pearson chi2 = 0.3244; Pr = 0.569), nocturia (t-test= 0.6646; Pr = 0.5076), number of UUI episodes (t-test =1.0610; Pr=0.2909) and ICIQ-SF (t-test=0.4221; Pr=0.6744). However, statistically significant differences are observed between the effectiveness of treatment and abandonment (Pearson chi2= 63.7032; Pr = 0.000).

Medication abandonment rate was established at 34%, a little below that indicated in the literature.
Regarding interactions, the only factor that influences in a statistically significant way is the effectiveness of the treatment.
Since there were no more factors, the multivariate study is not necessary.

Pharmacological treatment with anticholinergics in women affected by overactive bladder and UUI has an abandonment rate of 32% in our sample.
Our results indicate a statistically significant cause of treatment abandonment in our sample is the lack of treatment effectiveness.
The abandonment of anticholinergic treatment in our sample is not related to demographic variables or the clinical symptoms present at the time of the consultation.

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Sheyn D, Ju M, Zhang S et al. Development and Validation of a Machine Learning Algorithm for Predicting Response to Anticholinergic Medications for Overactive Bladder Syndrome. Obstet Gynecol 2019;134(5):946-57
Van Doorn T, Reuvers SH, Roobol MJ et al. Development of a prediction model in female pure or predominant urge urinary incontinence: a retrospective cohort study. Ther Adv Urol 2022;14:1–15