Urinary incontinence is a common presentation in general practice and can significantly affect a patient's quality of life. Stress urinary incontinence (SUI) is defined by the International Continence Society as 'the complaint of any involuntary loss of urine on effort or physical exertion (eg sporting activities), or on sneezing or coughing'. There is a key role for primary care providers in the assessment and management of female SUI.
To highlight the key diagnostic and management principles of female SUI in general practice and discuss management options.
SUI can usually be diagnosed based upon clinical history and targeted physical examination. Pelvic floor physiotherapy and lifestyle interventions, including weight modification and management of co-morbidities, are important first-line therapies. Surgical options for both persistent or complex SUI include urethral bulking agents, Burch colposuspension and pubovaginal fascial slings. Synthetic (mesh) mid-urethral slings remain a viable surgical option for women suffering SUI.
Australian journal of general practice. 2024 May [Epub]
Jodie McDonald, David Homewood, Courtenay West, Eva Fong, Sandra Elmer
MD, Surgical Registrar, Department of Urology, St Vincent@s Hospital, Melbourne, Vic., BSci, MD, Urology Research Registrar, Department of Urology, Western Health, Melbourne, Vic; Department of Surgery, University of Melbourne,@Melbourne, Vic; Research Fellow, International@Medical Robotics Academy, Melbourne, Vic., FRACS (Urol), Urologist, Department of Urology, Eastern Health, Melbourne, Vic., MBChB, BHB, FRACS (Urol), Urologist,@Department of Urology, Southern Cross Brightside@Hospital, Auckland, New Zealand., MBBS, MS, FRACS (Urol), Urologist, Department of Urology, Royal Melbourne Hospital, Melbourne, Vic; Urologist, Epworth Healthcare, Melbourne, Vic.