U-M guidelines help family physicians evaluate, manage urinary incontinence for women

September 13, 2012

Millions of women experience a loss of bladder control, or urinary incontinence, in their lifetime.

It's a common and often embarrassing problem that many patients don't bring up with their doctors – and when they do, it may be mentioned as a casual side note during a visit for more pressing medical issues.

Now, new guidelines from doctors at the University of Michigan Health System offer a step-by-step guide for the evaluation of urinary leakage, to prevent this quality-of-life issue from being ignored.

"I think a lot of physicians don't realize that this problem can be successfully treated without surgery or other major interventions and there are some pretty simple things they can do in the office to make a big difference for a lot of women," says lead author Abigail Lowther, M.D., clinical lecturer in the Department of . "We hope to give primary care providers a framework for how to evaluate and treat different many forms of incontinence without the need for referral to a specialist."

The U-M article was published in the this month.

Studies have found that 10 to 40 percent of women older than 18 years old – and as many as 53 percent of those over 50 – are affected by urinary incontinence. Among the long list of culprits are childbirth, aging and obesity.

Despite the prevalence of female incontinence, however, busy family physicians may not hear about the problem until well into a visit focused on separate – and some doctors may not feel like they can help.

But the paper suggests three simple, immediate steps a physician can take to address the problem while keeping the appointment on track: Collecting a , asking the patient to keep a diary that charts fluid intake and urination and scheduling a follow-up visit.

By the second visit, the physician will have more information for further evaluation and a management plan. High-yield questions will also classify the type of incontinence being experienced. Questions may include asking how worried patients are that coughing will lead to a leak, how quickly patients need to find a bathroom when their bladder is full and whether washing hands – or the sound of running water – leads to leakage.

of all types can be a great disruption to daily activities, ranging from occasionally leaking urine after a cough or sneeze to having an urge so sudden that patients may not make it to the bathroom in time. For some, bladder leakage may be a symptom of another underlying medical condition.

Lowther says some women don't broach the subject with doctors because they think loss of bladder control is a normal part of aging. But left untreated, it may get worse with time and lead to more restrictions, she says.

"We want to emphasize to women that this is not something they have to live with, that they should tell their primary care physicians about their symptoms," Lowther says. "We also want to remind physicians that simple interventions can go a long way towards improving this problem for patients."

Explore further: Findings provide guide to decisions on use of slings for women's prolapse surgery

More information: "Managing incontinence: A 2-visit approach," Journal of Family Practice, September 2012, Vol. 61, No.9.

Related Stories

Findings provide guide to decisions on use of slings for women's prolapse surgery

June 20, 2012
A multicenter study involving a UT Southwestern Medical Center urogynecologist will eliminate some of the guesswork physicians face about whether to use a sling during vaginal prolapse repair to prevent urinary incontinence.

Invasive bladder testing before incontinence surgery may be unnecessary

May 2, 2012
Invasive and costly tests commonly performed on women before surgery for stress urinary incontinence (SUI) may not be necessary, according to researchers at the University of California San Diego, School of Medicine and the ...

Bladder 'pacemaker' can fix overactive bladder, other voiding issues

April 29, 2011
If your day is punctuated by urgent trips to the bathroom or trouble emptying your bladder, you might have a voiding dysfunction condition. The good news is that it can be easily treated.

Urinary incontinence doubles risk of postpartum depression

June 20, 2011
Women with urinary incontinence after giving birth are almost twice as likely to develop postpartum depression as those without incontinence, according to a new study led by Wendy Sword, a professor in McMaster University's ...

Recommended for you

Will these two home remedies help your sore throat?

December 18, 2017
(HealthDay)—Down go another two worthless home remedies for strep throat.

Simple tool may expedite transplants in kids with kidney failure

December 18, 2017
An easy-to-use tool to predict the likelihood of a child with kidney disease progressing to kidney failure has a high degree of accuracy and could be used to reduce the burden of dialysis and increase transplantations, according ...

New cellular approach found to control progression of chronic kidney disease

December 15, 2017
Researchers have demonstrated for the first time that extracellular vesicles - tiny protein-filled structures - isolated from amniotic fluid stem cells (AFSCs) can be used to effectively slow the progression of kidney damage ...

Testing shows differences in efficacy of Zika vaccines after one year

December 15, 2017
(Medical Xpress)—A large team of researchers with members from Harvard Medical School, Walter Reed Army Institute of Research, Bioqual Inc. and MIT has found that the efficacy of the three types of Zika vaccines currently ...

How to regulate fecal microbiota transplants

December 15, 2017
(Medical Xpress)—A small team of researchers at the University of Maryland, some with affiliations to the Veterans Affairs Maryland Health Care System, has written and published a Policy Forum piece in the journal Science ...

Screening could catch a quarter of hip fractures before they happen

December 15, 2017
Community screening for osteoporosis could prevent more than a quarter of hip fractures in older women - according to new research led by the University of East Anglia (UEA).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.