The following guidelines provide clinical recommendations on the treatment of urinary incontinence in women.
For the treatment of stress urinary incontinence (the involuntary leakage of urine with a physical activity such as coughing or sneezing), the American College of Physicians recommends first-line treatment with pelvic floor muscle training (exercises during which the pelvic floor muscles are squeezed and lifted, and then relaxed, several times in a row). High-quality evidence shows that pelvic floor training results in significant improvements in quality of life and urinary function. The use of medications is currently not recommended in the case of stress incontinence, although there is a lack of high-quality evidence on the subject.
Bladder training (behavioral training that extends the time between urinations) is the first-line recommendation for women with urgency urinary incontinence (the involuntary leakage of urine accompanied by a strong need to urinate). The American College of Physicians currently recommends medications for urgency urinary incontinence only if bladder training was unsuccessful in resolving symptoms. High-quality evidence has shown that the different drug options have similar benefits. Therefor, the choice of drug should be based on side effect profile, ease of use, and cost of medication.
A combination of pelvic floor muscle training and bladder training is recommended for women with mixed incontinence (women with both stress and urge incontinence).
Weight loss and exercise is recommended for obese women with urinary incontinence.
Published By :
Annals of internal medicine
Sep 16, 2014
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