Conservative management of urinary incontinence in women

Urinary incontinence (UI) is now recognized as a growing health care problem and a personal concern for women. UI is felt to be a significant aging health issue for women. Much is known about the prevalence of UI in women. Almost one third (31%) of women between the ages of 42 and 50 and two in five (38%) women over the age of 60 suffer from UI. Urine leakage varies, with about 1 in 10 women leaking enough urine that it soaks through underclothes. About one in three (30%) women have problems with incontinence during pregnancy. Society incurs a significant economic burden as a result of UI, which cost the Medicare Part A program $26.3 billion in 1995. One of the biggest obstacles to effective management of incontinence is the perception that incontinence is inevitable and irreversible, a perception almost as common among health care providers as patients. Therefore, most women do not report their UI problem to primary care practitioners. Primary care practitioners are in a key position to influence prevention, screen for incontinence, and improve outcomes of women at risk for incontinence. Current research supports the value of noninvasive, conservative treatment strategies, education, and emotional support.