GuidelinesEML (Adult Hospital STG)
Urinary Incontinence
Description Stress Incontinence Urgency Incontinence DESCRIPTION The involuntary leak of urine. Occurs in 10-17% of all women. Risk factors include: Age (prevalence and severity increase with age), increased parity, obesity, smoking, caffeine intake, diabetes and menopausal vaginal atrophy. Most common types are stress incontinence, urgency incontinence (overactive bladder) or a mixed incontinenc
DESCRIPTION
- The involuntary leak of urine. Occurs in 10-17% of all women.
- Risk factors include: Age (prevalence and severity increase with age), increased parity, obesity, smoking, caffeine intake, diabetes and menopausal vaginal atrophy.
- Most common types are stress incontinence, urgency incontinence (overactive bladder) or a mixed incontinence (features of both stress and urgency).
STRESS INCONTINENCE
ICD-10 code: N39.3
DESCRIPTION
- Incontinence that occurs with increased abdominal pressure (e.g. cough, sneeze or laugh) in the absence of a bladder contraction.
GENERAL MEASURES
- Exclude urinary tract infection or diabetes.
- Pelvic examination to exclude pelvic masses, pelvic organ prolapse, or menopausal vaginal atrophy.
- Stop smoking.
- Manage obesity.
- Reduce or avoid caffeine.
- Reduce alcohol intake.
- Manage constipation and avoid excessive fluid intake.
- Keep a bladder diary.
- Pelvic floor exercises (see: Overactive bladder).
MEDICINE TREATMENT
There is insufficient evidence for the use of pharmacological interventions to treat stress incontinence.
REFERRAL
- If any pelvic pathology, immediate referral to specialist.
- If no underlying pathology, refer for bladder stress testing if no improvement with conservative measures after 3-6 months.
URGENCY INCONTINECE (OVERACTIVE BLADDER)
See Overactive bladder.
Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 5: Gynaecology; Version 1.0, 2020-4_June 2024