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Clinical investigations from the RACP

Assessing urinary incontinence in women: how can we help a wee problem?

George Szonyi

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Abstract

In most patients, a diagnosis can be reached from history, examination, urinalysis and culture, a bladder diary and (in some cases) measurement of postvoid residual urine volume.

Key Points

  • Urinary incontinence affects between 25 and 45% of women at some time in their lives.
  • GPs are ideally placed to initiate management.
  • Reversible causes should be sought, particularly medications such as diuretics and antihypertensive drugs (including prazosin).
  • History, examination, urinalysis, urine culture, a bladder diary and (in selected cases) measurement of postvoid residual urine volume are sufficient for a diagnosis in most cases.
  • Pelvic floor exercises and bladder training can be effective treatments.
  • Specialist referral should be considered for patients who do not respond to these measures.

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