[Female urinary incontinence: diagnosis and treatment]

Female urinary incontinence: diagnosis and treatment Abstract. Urinary incontinence (UI) is a common condition that may affect women of all ages, with a wide range of severity and nature. Although rarely life threatening, UI may seriously influence the physical, psychological and social wellbeing of affected individuals. The two main types are Stress and Urge Urinary Incontinence. A new and important term is used, the overactive bladder syndrome (OAB), which is defined as urgency that occurs with or without urge UI and usually with frequency and nocturia. Stress Urinary Incontinence (SUI) is the result of weak urethral muscle and support. Urge Urinary Incontinence (UUI) is the result of over active bladder muscle. History and physical examination, including vaginal exam and measuring postvoidal residual volume establish the diagnosis, and a urinary tract infection should be ruled out. Therapy consists of behavioral modification. For SUI pelvic floor physiotherapy (Kegel exercises with or without aid of physical therapist) is important, also, devices such as a pessary or urethral insert can be used. When symptoms persist, surgery (typically a synthetic mesh sling) is indicated. In selected cases, transurethral bulking agent injections can be discussed. For OAB or UUI also physiotherapy as well as medications such as antimuscarinics or the recently released beta-3-adrenoreceptor-agonist Mirabegron are well established. In case of failure intravesical botox application is a good option.