Incontinence

Question 1

What are risk factors for incontinence?

Answer 1

Age
Previous pregnancy/childbirth
High BMI
Hysterectomy
FH

Question 2

What are features/management of stress incontinence?

Answer 2

Leaking small amounts of urine when coughing/laughing

Treatment
1) Pelvic floor training
2) Refer to gynae for surgery OR if not wanting surgery then duloxetine

Question 3

What are features/management of urge incontinence?

Answer 3

Sudden need to pass urine with incontinence

Treatment
1) Bladder retraining for at least 6 weeks
2) Antimuscarinic eg. oxybutynin/tolterodine, darifenacin
- avoid oxybutynin in older women due to risk of Se/cognitive impairment
3) Mirabegron if antimuscarinic contraindicated

If nocturia troublesome consider desmopressin