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Treatment of urinary incontinence in women in general practice: observational study
A Seim1, B Sivertsen, B C Eriksen
1Medical Office of Health, Rissa, Norway.
Objective:
To examine what is attainable when treating urinary incontinence in women in general practice.
Design:
Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice.
Setting:
General practice in the rural district of Rissa, Norway.
Subjects:
105 women aged 20 or more with urinary incontinence.
Interventions:
Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads.
Main Outcome Measures:
Subjective and objective measures of urinary incontinence; number of patients referred to a specialist.
Results:
After 12 months' follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist.
Conclusions:
Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results.