Which of the following is the first-line treatment for overflow incontinence?

Intermittent catheters are considered the first-line treatment for overflow incontinence because this condition is characterized by the bladder being unable to effectively empty, leading to retention and subsequent overflow. The use of intermittent catheterization allows for the periodic removal of retained urine, alleviating the symptoms associated with overflow incontinence.

This approach helps to reduce the risk of complications related to urinary retention, such as urinary tract infections and bladder distension, by enabling complete bladder emptying. It is particularly useful in patients who have difficulty initiating urination due to underlying conditions such as bladder outlet obstruction or neurological disorders.

In contrast, other treatment options such as antibiotics, cholinergics, and alpha blockers target different aspects of urinary function or bladder control. Antibiotics would only be indicated if there is a concurrent urinary tract infection, while cholinergics would stimulate bladder contraction, which is not effective in overflow situations where the issue is retention rather than lack of bladder activity. Alpha blockers may help in relieving obstruction due to prostate issues but are not the primary choice for managing overflow incontinence specifically.