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Vol 37, (3) 106-110

Urinary incontinence - Pathophysiology and management outline

Stanley K Santiagu MBBCh, is resident medical officer, Department of Urology, Port Macquarie Base Hospital, Port Macquarie, New South Wales.

Mohan Arianayagam BSc, MBBS, is a registrar, Department of Urology, Port Macquarie Base Hospital, Port Macquarie, New South Wales.

Audrey Wang FRACS, is Clinical Fellow, Department of Urology, Westmead Hospital, Sydney, New South Wales.

Prem Rashid MBBS, FRACGP, FRACS(Urol), PhD, is a urological surgeon, Port Macquarie Base Hospital, and Conjoint Associate Professor, Rural Clinical School, University of New South Wales, Port Macquarie, New South Wales.

BACKGROUND Urinary incontinence is common in the community and may impact significantly on quality of life; yet only one-third of sufferers seek medical attention. There are many treatment options for patients suffering with urinary incontinence.

OBJECTIVE This article aims to aid general practitioners in the managment urinary incontinence. We outline the pathophysiology of urinary incontinence in women and provide a primary care treatment paradigm. Suggestions for when specialist referral would be of benefit are also discussed.

DISCUSSION Most urinary incontinence can be evaluated and treated in the primary care setting after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle treatment. Urinary urgency responds to bladder training and pharmacotherapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence. If there is complex symptomatology or primary management fails, then referral to a specialist is suggested.

Publication Date: 5 March 2008
Authorised By: Australian Family Physician