Treatment of urinary incontinence in women in general practice: observational study.

Abstract Objective : To examine what is attainable when treating urinary incontinence in women in general practice. Design : Observational study with 12 months9 follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice. Setting : General practice in the rural district of Rissa, Norway. Subjects : 105 women aged 20 or more with urinary incontinence. Interventions : Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads. Main outcome measures : Subjective and objective measures of urinary incontinence; number of patients referred to a specialist. Results : After 12 months9 follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist. Conclusions : Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results. Key messages General practitioners can treat urinary inconti- nence fairly simply Treatment options in this study were pelvic floor exercises, electrostimulation, oestrogen, anti- cholinergic drugs, bladder training, and protective pads After 12 months9 follow up most of the women were cured or much better