Urinary Incontinence in Women: A Review
| Autor: | Linda Brubaker, Emily S. Lukacz, Michael E. Albo, Yahir Santiago-Lastra |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Urologic Diseases
Stress incontinence medicine.medical_specialty Aging Sling (implant) Percutaneous Referral Urinary Incontinence Stress Clinical Trials and Supportive Activities 030232 urology & nephrology MEDLINE Renal and urogenital Urinary incontinence Stress Medical and Health Sciences Cholinergic Antagonists 7.3 Management and decision making 03 medical and health sciences 0302 clinical medicine Gynecologic Surgical Procedures Weight loss Clinical Research General & Internal Medicine medicine Humans Intensive care medicine Exercise Life Style Urge Suburethral Slings 030219 obstetrics & reproductive medicine business.industry Health condition Urinary Incontinence Urge General Medicine medicine.disease Urinary Incontinence Quality of Life Female medicine.symptom business Digestive Diseases |
| Zdroj: | JAMA, vol 318, iss 16 Lukacz, ES; Santiago-Lastra, Y; Albo, ME; & Brubaker, L. (2017). Urinary Incontinence in Women A Review. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 318(16), 1592-1604. doi: 10.1001/jama.2017.12137. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/8p0291rf |
| Popis: | Importance Urinary incontinence, the involuntary loss of urine, is a common health condition that may decrease quality of life. Ten to twenty percent of women and up to 77% of women residing in nursing homes have urinary incontinence, yet only 25% seek or receive treatment. Observations This review summarizes the evaluation and therapeutic options for women affected by urinary incontinence. The initial assessment should focus on understanding the effect of incontinence on quality of life, the patient’s goals and preferences for treatment, the results of previous treatments, and the presence of concomitant conditions, such as advanced pelvic organ prolapse, that may require referral. Infection and hematuria need to be ruled out. In the absence of urinary infection or serious underlying pathology (such as cancer or serious neurologic disease) associated with urinary incontinence, the clinician should initiate unsupervised pelvic muscle exercises and lifestyle modifications appropriate to the patient to reduce her symptoms. These recommendations can include weight loss, adequate hydration, avoidance of excessive fluids, and regular voiding intervals that reduce urgency incontinence episodes. Urgency incontinence medications, with timely reassessment of symptoms, can be started without extensive evaluation. Specialist treatments for urgency incontinence include onabotulinumtoxinA and percutaneous or implanted neuromodulators. Stress incontinence surgery, the midurethral sling, is associated with symptom improvement in 48% to 90% of women and has low rates of mesh complications ( Conclusions and Relevance Urinary incontinence is common in women, although few seek care despite many effective treatment options. Clinicians should prioritize urinary incontinence detection, identify and treat modifiable factors, incorporate patient preference into evaluation and treatment, initiate conservative and medical therapy, and refer to specialists when underlying pathology is identified or conservative measures are ineffective. |
| Databáze: | OpenAIRE |
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