Urinary incontinence. No need to be wet and upset

Over 17 million people in the United States suffer from urinary incontinence. UI limits functional and social activities and is a common cause of anxiety, social withdrawal, and depression. Primary care providers should take a proactive approach in searching for the presence of, and then investigating the reasons for, incontinence. Usually the diagnosis is apparent from the data obtained from a good history, physical examination, measurement of post-voiding residual urine, and urinalysis. A voiding diary can quantify the magnitude of the problem and response to treatment. Conservative treatment options include behavioral techniques such as timed or prompted voiding, changes in diet, pelvic floor exercises, and medications. If these measures fail, referral to a urological surgeon is appropriate so that further diagnostic studies can be offered as well as minimally invasive procedures or surgery.