Long-term effect of treatment of female incontinence in general practice

Urinary incontinence in women can be treated successfully by the general practitioner. However, little is known about the long-term effects of conservative treatment.

To evaluate the long-term effect of treatment of female incontinence by the general practitioner (pelvic floor exercises, and bladder training) in female urinary incontinence.

A total of 88 women, aged between 20 and 65, who had participated in a controlled trial between 1987 and 1990, were contacted to participate in a five-year follow-up study. Stress incontinence and urge incontinence were treated by means of pelvic floor exercises and bladder training respectively, while a mixed incontinence was treated by bladder training followed by pelvic floor exercises. The outcome measures were a constructed scale for the severity of the incontinence, a seven-day bladder chart, and a questionnaire concerning patients' opinions. All patients were evaluated by an independent researcher.

Compared with the one-year follow-up, the number of continent women remained the same, but a significantly greater number of patients worsened. Forty per cent of the women stayed in the same category of severity, while 45% moved into the contiguous categories. The weekly frequency of wet episodes increased significantly, with a mean increase of 2.65 episodes. Women with mixed incontinence were especially prone to relapse in the long-term. Compliance with the exercises had a positive influence on the outcomes, with 67% of the women expressing satisfaction with the results.

Despite a decline in the effect of conservative treatment in the long-term, the majority of the women are satisfied with their treatment. Patient compliance is the key to long-term success.