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Feature Article

Treating urge urinary incontinence

Richard J Millard
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Abstract

Help is available for patients with urge urinary incontinence, one of the most common bladder complaints seen in general practice. Bladder training programs, with or without drug therapy, and specialist referral in some cases can help motivated patients remain dry.

Key Points

  • Urge urinary incontinence is caused by bladder overactivity and is one of the most common bladder complaints seen in general practice. It involves a strong desire to void with the bladder contracting inappropriately without its owner’s permission.
  • The condition should not be confused with stress incontinence, which is caused by sphincter weakness. However, the two may occur concurrently, especially in the elderly.
  • Patient assessment should include history, examination, urinalysis, post void residual urine and a urinary diary.
  • Bladder training programs are the best treatment and can be conducted with or without anticholinergic drug therapy. Management can be in consultation with a nurse continence adviser. If specialist referral is necessary, treatment may include further drug therapy, electrical stimulation, surgery or catheterisation.

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