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Introduction to urinary incontinence

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Urinary incontinence is defined as the involuntary loss of urine. It is a benign, distressing and embarrassing condition affecting up to 25% of women and can lead to a significant restriction in the lifestyles of affected individuals.

This eTutorial explores the management options for different types of urinary incontinence – from behavioural therapies through to drugs and surgery. It looks at modern methods of achieving an efficient, cost-effective solution that embraces community and hospital practice within a multi-disciplinary approach.

To fully appreciate this eTutorial, you will need to be familiar with the Assessment of lower urinary tract symptoms tutorial.

Learning objectives

When you have completed this tutorial you will be able to:

  • understand the initial management of patients prior to urodynamic assessment (which, according to NICE guidelines, will be carried out by GPs)
  • understand the role and technique of conservative measures and how these should be explained to patients
  • have an awareness of the role of continence advisors and specialist physiotherapists
  • understand the role of medication in the management of lower urinary tract symptoms
  • have an awareness of the range of surgical measures for stress incontinence, with emphasis on mid-urethral tapes
  • understand modern surgical measures for detrusor overactivity, including botulinum toxin A bladder wall injection and neuromodulation, with an awareness of more traditional surgical procedures
  • understand the management of other conditions, such as voiding dysfunction and fistula.

Last updated:12/01/12 (section on Management of stress incontinence was updated by Pallavi Latthe)

10/03/09 (BJOG paper added in the Preliminary reading'and 'Management of the overactive bladder' sections)

4/03/09 (BJOG paper added in the 'Preliminary reading', 'Epidemiology – Risk factors for stress urinary incontinence' and 'Epidemiology – Pregnancy' sections).

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