[Approach to urinary incontinence in women]

Urinary incontinence is a very common problem in women; it can lead to a specific alteration of quality of life which is necessary to evaluate before any treatment. Various types of incontinence can be described: stress incontinence, urge incontinence, mixed incontinence. Clinical examination is always necessary to exclude a specific cause of incontinence particularly neurogenic dysfunction in which incontinence may be the first symptom before motor or sensitive alterations appearance. Urodynamic investigations can easily determine pathophysiologic factors and allow a best choice of therapeutic strategies. Concerning stress urinary incontinence, first line treatment consists of pelvic floor exercices before surgical therapy, and anticholinergic drugs are always tried in urge incontinence before sacral neuromodulation.