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Treatment of urinary incontinence in women

Author
Emily S Lukacz, MD, MAS
Section Editors
Linda Brubaker, MD, FACOG
Kenneth E Schmader, MD
Deputy Editor
Judith A Melin, MA, MD, FACP

INTRODUCTION

Urinary incontinence, the involuntary leakage of urine, is often underdiagnosed and undertreated [1-3]. In one survey, only 60 percent of patients seeking care for leakage (at least once weekly) recalled receiving any treatment for their incontinence [4]. Additionally, nearly 50 percent of those who did receive treatment reported moderate to great frustration with ongoing incontinence.

This topic will discuss the treatment of urinary incontinence in nonpregnant women, focusing on the initial management of stress and stress predominant mixed urinary incontinence.

Overactive bladder (OAB) is a syndrome characterized by urinary urgency, frequency, and nocturia with or without incontinence, and it is treated in a similar manner to urgency incontinence. The treatment of urgency urinary incontinence, OAB and urge predominant mixed urinary incontinence is described separately. (See "Treatment of urgency incontinence/overactive bladder in women".)

The evaluation of urinary incontinence in women and urinary incontinence in men are discussed separately. Urinary incontinence in pregnancy is also discussed separately. (See "Urinary incontinence in men" and "Evaluation of women with urinary incontinence" and "Urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth".)

PRIOR TO INITIATING TREATMENT

Identify indications for referral — Indications for further evaluation or referral for treatment of urinary incontinence include the presence of associated abdominal/pelvic pain, gross or microscopic hematuria in the absence of urinary tract infection, culture-documented recurrent urinary tract infections, new neurologic symptoms, suspected urinary fistula or urethral diverticulum, chronic catheterization, difficulty passing a urinary catheter, pelvic organ prolapse beyond the hymen, history of pelvic reconstructive surgery or pelvic irradiation, or persistently elevated postvoid residual (after treatment of possible causes). (See "Evaluation of women with urinary incontinence", section on 'Specialist referral'.)

                          
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Literature review current through: Nov 2017. | This topic last updated: Nov 09, 2017.
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