Korean J Fam Pract.  2022 Sep;12(4):217-222. 10.21215/kjfp.2022.12.4.217.

Diagnosis and Treatment of Urinary Incontinence in Female Patients

• Shin JH

• KMID: 2533233
• DOI: http://doi.org/10.21215/kjfp.2022.12.4.217

Abstract

Urinary incontinence (UI), an involuntary loss of urine, is classified by clinical situation. The most common UI cases include stress UI (SUI), the involuntary loss of urine on effort or physical exertion or on sneezing or coughing; urgency UI (UUI), the involuntary loss of urine associated with urgency (a sudden, compelling desire to pass urine); and mixed UI, which includes both SUI and UUI. The diagnosis of UI includes a comprehensive review of lower urinary tract symptoms, past medical history, physical examination, and three-day voiding diary. The diagnosis of UI is very important as management plans differ by type. Treatment options for SUI include conservative therapy such as pelvic floor exercises (Kegels), biofeedback, and surgery. Anti-incontinence surgery for SUI is more effective than conservative therapy. UUI is closely related to overactive bladder (OAB), urinary urgency that is usually accompanied by increased daytime frequency and/or nocturia, with or without UUI in the absence of urinary tract infections or other detectable diseases. First- and second-line treatments for OAB include behavioral and pharmacological therapy. Pharmacological agents for OAB include antimuscarinics and β3 adrenoceptor agonists. As the superiority of any particular medication lacks evidence, patient safety and persistence of various therapies require consideration in individual settings. Increased risks of cognitive dysfunction caused by the long-term use of antimuscarinics and concerns of anticholinergic burden in frail elderly patients with polypharmacy were recently highlighted.

Keyword

Urinary Incontinence; Urinary Incontinence; Stress; Urinary Bladder; Overactive; Lower Urinary Tract Symptoms