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Female Urinary Incontinence

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Essential Urology

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Urinary incontinence (UI) has long been recognized as a prevalent and morbid, but treatable problem for women of all ages. Despite this, only a minority of those affected seek care and many of those do not receive effective therapy. It is imperative that primary care providers work with urologists and gynecologists to identify women with UI and provide efficient evaluation and appropriate treatment.

This chapter provides an overview of the epidemiology and risk factors for UI. A practical approach to evaluation is offered with a goal of producing a working diagnosis of stress, urge, or mixed incontinence. With the diagnosis and a knowledge of the patient’s goals the clinician can initiate therapy in the majority of cases. In the treatment section there is an emphasis on evidence-based, nonsurgical, non-pharmacologic therapy although these modalities are fully reviewed. The indications for referral, types of testing provided by incontinence specialists, and newer advanced treatment options such as neuromodulation and botulinum toxin bladder injections are also presented.

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References

  1. Hu TW, Wagner TH, Bentkover JD, Leblanc K, Zhou SZ, Hunt T. Costs of urinary incontinence and overactive bladder in the United States: a comparative study. Urology. 2004;63(3):461–5.

    Article  PubMed  Google Scholar 

  2. Cost of illness summaries for selected conditions. RTI International. January 2006. http://www.rti.org/files/COI_Summaries.pdf. Accessed 6 Mar 2012.

  3. Kinchen KS, Lee J, Fireman B, Hunkeler E, Nehemiah JL, Curtice TG. The prevalence, burden, and treatment of urinary incontinence among women in a managed care plan. J Womens Health (Larchmt). 2007;16(3):415–22.

    Article  Google Scholar 

  4. Steers WD, Lee KS. Depression and incontinence. World J Urol. 2001;19(5):351–7.

    Article  PubMed  CAS  Google Scholar 

  5. Shaw C. A review of the psychosocial predictors of help-seeking behaviour and impact on quality of life in people with urinary incontinence. J Clin Nurs. 2001;10(1):15–24.

    Article  PubMed  CAS  Google Scholar 

  6. Fantyl JA, Newman DK, Colling J, et al. Urinary incontinence in adults: acute and chronic management. Clinical Practice Guideline, No. 2, 1996 Update. Rockville: US Department of Health and Human Services. Public Health Service, Agency for Health Care Policy and Research. AHCPR Publication No. 96-0682. March 1996.

    Google Scholar 

  7. Published by the RCOG Press at the Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent’s Park, London NW1 4RG. 2006. http://www.nice.org.uk/nicemedia/live/10996/30282/30282.pdf. Accessed 6 Mar 2012.

  8. American College of Obstetricians and Gynecologists (ACOG). Urinary incontinence in women. Washington; 13 pp. (ACOG practice bulletin no. 63). June 2005. http://www.guidelines.gov/content.aspx?id=10931. Accessed 6 Mar 2012.

  9. Guideline for the Surgical Management of Female Stress Urinary Incontinence: Update, American Urological Association Guidelines Department, Linthicum. 2009. http://www.auanet.org/content/­clinical-practice-guidelines/clinical-guidelines.cfm?sub=stress2009. Accessed 6 Mar 2012.

  10. Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009.

    Google Scholar 

  11. Payne CK. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Wein AJ, Kavoussi LR, Novick A, Partin A, Peters C, editors. Campbell-Walsh urology. 10th ed. Philadelphia: Elsevier; 2011. p. 2003–25.

    Google Scholar 

  12. Wein AJ. Pathophysiology and classification of lower urinary tract dysfunction: overview. In: Wein AJ, Kavoussi LR, Novick A, Partin A, Peters C, editors. Campbell-Walsh urology. 10th ed. Philadelphia: Elsevier; 2011. p. 1834–46.

    Google Scholar 

  13. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2002;61(1):37–49.

    Article  Google Scholar 

  14. Milsom I, Altman D, Lapitan MC, Nelson R, Sillen U, Thom D. Epidemiology of urinary and fecal incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 35–110.

    Google Scholar 

  15. McGrother CW, Donaldson MM, Hayward T, Matthews R, Dallosso HM, Hyde C, Leicestershire MRC Incontinence Study Team. Urinary storage symptoms and comorbidities: a prospective population cohort study in middle-aged and older women. Age Ageing. 2006;35(1):16–24 [Epub 2005 Oct 18].

    Article  PubMed  Google Scholar 

  16. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S, Norwegian EPINCONT Study. Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med. 2003;348(10):900–7.

    Article  PubMed  Google Scholar 

  17. Townsend MK, Curhan GC, Resnick NM, Grodstein F. BMI, waist circumference, and incident urinary incontinence in older women. Obesity (Silver Spring). 2008;16(4):881–6 [Epub 2008 Feb 14].

    Article  Google Scholar 

  18. Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F. Body mass index, weight gain, and incident urinary incontinence in middle-aged women. Obstet Gynecol. 2007;110(2 Pt 1):346–53.

    Article  PubMed  Google Scholar 

  19. Urinary Incontinence Guideline Panel. Urinary incontinence in adults: clinical practice guideline. AHCPR Pub No 92-0038, Rockville: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services; 1992.

    Google Scholar 

  20. American College of Surgeons PRQI flow sheet for Urinary Incontinence. http://www.facs.org/ahp/pqri/pdfs/urinary-incontinence.pdf. Accessed 6 Mar 2012.

  21. American Urologic Association Medicare PRQI Incontinence reporting tool at http://www.auanet.org/content/legislative-and-regulatory/payment-and-reimbursement/pqri-toolkit/medquacode.pdf. Accessed 6 Mar 2012.

  22. Staskin D, Kelleher C, Avery K, et al. Initial assessment of urinary and faecal incontinence in adult male and female patients. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 331–49.

    Google Scholar 

  23. Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299(12):1446–56.

    Article  PubMed  CAS  Google Scholar 

  24. Resnick NM. Urinary incontinence in the elderly. Med Grand Rounds. 1984;3:281–90.

    Google Scholar 

  25. Hosker G, Rosier P, Gajewski J, Sand P, Szabo L, Capewell A. Dynamic testing. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 442–50.

    Google Scholar 

  26. Nager CW, FitzGerald M, Kraus SR, et al. Urodynamic measures do not predict stress continence outcomes after surgery for stress urinary incontinence in selected women. J Urol. 2008;179(4):1470–4.

    Article  PubMed  Google Scholar 

  27. Nager CW, Sirls L, Litman HJ, et al. Baseline urodynamic predictors of treatment failure 1 year after mid urethral sling surgery. J Urol. 2011;186(2):597–603.

    Article  PubMed  Google Scholar 

  28. Tries J, Eisman E. Urinary incontinence: evaluation and biofeedback treatment. In: Schwartz MS, editor. Biofeedback: practitioner’s guide. New York: Guilford Press; 1995.

    Google Scholar 

  29. Tubaro A, Artibani W, Bartram C, et al. Imaging and other investigations. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 546–9.

    Google Scholar 

  30. Hay-Smith J, Berghmans B, Burgio K, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 1025–82.

    Google Scholar 

  31. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int. 2003;92(1):69–77.

    Article  PubMed  CAS  Google Scholar 

  32. Auwad W, Steggles P, Bombieri L, Waterfield M, Wilkin T, Freeman R. Moderate weight loss in obese women with urinary incontinence: a prospective longitudinal study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(9):1251–9 [Epub 2008 Apr 18].

    Article  PubMed  Google Scholar 

  33. Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90.

    Article  PubMed  CAS  Google Scholar 

  34. Danforth KN, Shah AD, Townsend MK, Lifford KL, Curhan GC, Resnick NM, Grodstein F. Physical activity and urinary incontinence among healthy, older women. Obstet Gynecol. 2007;109(3):721–7.

    Article  PubMed  Google Scholar 

  35. Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F. Physical activity and incident urinary incontinence in middle-aged women. J Urol. 2008;179(3):1012–6. discussion 1016–7 [Epub 2008 Jan 18].

    Article  PubMed  Google Scholar 

  36. Wilson PD, Berghmans B, Hagen S, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. Paris: Health Publications Ltd; 2005.

    Google Scholar 

  37. Danforth KN, Townsend MK, Curhan GC, Resnick NM, Grodstein F. Type 2 diabetes mellitus and risk of stress, urge and mixed urinary incontinence. J Urol. 2009;181(1):193–7 [Epub 2008 Nov 14].

    Article  PubMed  Google Scholar 

  38. Goode PS, Burgio KL, Locher JL, et al. Effect of behavioral training with or without pelvic floor electrical stimulation on stress incontinence in women: a randomized controlled trial. JAMA. 2003;290(3):345–52.

    Article  PubMed  Google Scholar 

  39. van Kerrebroeck P, Abrams P, Lange R, et al. Duloxetine versus placebo in the treatment of European and Canadian women with stress urinary incontinence. BJOG. 2004;111(3):249–57.

    Article  PubMed  Google Scholar 

  40. Millard RJ, Moore K, Rencken R, Yalcin I, Bump RC, Duloxetine UI Study Group. Duloxetine vs placebo in the treatment of stress urinary incontinence: a four-continent randomized clinical trial. BJU Int. 2004;93(3):311–8.

    Article  PubMed  CAS  Google Scholar 

  41. Hurley DJ, Turner CL, Yalcin I, Viktrup L, Baygani SK. Duloxetine for the treatment of stress urinary incontinence in women: an integrated analysis of safety. Eur J Obstet Gynecol Reprod Biol. 2006;125(1):120–8.

    Article  PubMed  CAS  Google Scholar 

  42. Castro-Diaz D, Palma PC, Bouchard C, et al. Effect of dose escalation on the tolerability and efficacy of duloxetine in the treatment of women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(8):919–29.

    Article  PubMed  Google Scholar 

  43. Payne C. Management of overactive bladder. Part II: how to use medications. AUANews. 2010;15(11):11.

    Google Scholar 

  44. Smith ARB, Dmochowski R, Hilton P, Rovner E, Nillson CG, Reid FM, Chang D. Surgery for urinary incontinence in women. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth: Health Publications Ltd; 2009. p. 1191–237.

    Google Scholar 

  45. Peters KM, Carrico DJ, Perez-Marrero RA, Khan AU, Wooldridge LS, Davis GL, Macdiarmid SA. Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183(4):1438–43.

    Article  PubMed  Google Scholar 

  46. Macdiarmid SA, Peters KM, Shobeiri SA, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol. 2010;183:234–40.

    Article  PubMed  Google Scholar 

  47. Schmidt RA, Jonas U, Oleson KA, et al. Sacral nerve stimulation for treatment of refractory urinary urge incontinence. J Urol. 1999;162:352–7.

    Article  PubMed  CAS  Google Scholar 

  48. Hassouna MM, Siegel SW, Nyeholt AA, et al. Sacral neuromodulation in the treatment of urgency-frequency symptoms: a multicenter study on efficacy and safety. J Urol. 2000;163:1849–54.

    Article  PubMed  CAS  Google Scholar 

  49. Payne C. Management of overactive bladder. Part III: refractory OAB. AUANews. 2011;16(10):10.

    Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Stanford University, 300 Pasteur Drive, A260, Stanford, CA, 94305-5118, USA

    Christopher K. Payne

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  1. Christopher K. Payne
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Correspondence to Christopher K. Payne .

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Editors and Affiliations

  1. Men's Health Consultant, 900 Welch Road, Suite 202, Palo Alto, 94305, USA

    Jeannette M. Potts

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Payne, C.K. (2012). Female Urinary Incontinence. In: Potts, J. (eds) Essential Urology. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-092-2_8

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  • DOI: https://doi.org/10.1007/978-1-62703-092-2_8

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-091-5

  • Online ISBN: 978-1-62703-092-2

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