Work-Up of Urinary Incontinence in Woman
摘要
Urinary incontinence is highly prevalent in women of all ages worldwide. It has significant impact on quality of life and is associated with considerable financial burden. There are two main types of urinary incontinence, stress urinary incontinence in which the urine leak is associated with physical exertion like coughing, sneezing, etc. In urge urinary incontinence, the urine leak occurs due to sudden compelling desire to void. When the patient presents with both of these symptoms, it is termed as mixed urinary incontinence. Thorough assessment of any type of urinary incontinence involves detailed history, examination and judicious use of relevant investigations. The baseline investigations include checking for urine infection, bladder diary, flow rate and post-void residual assessment supplemented with use of validated questionnaires to assess symptoms, bother and effect on quality of life. Invasive urodynamics is indicated if the conservative and/or pharmacological management fails or patient has history of complex pelvic or anti-incontinence surgery. A small group of patients may need additional investigations. Recommendations from various scientific (urological and urogynaecological) societies are available to provide robust evidence on evaluation of these patients. However, the evaluation and management should follow a patient-centred approach.