MSRA: Urinary Incontinence

Question 1

What is the management of stress urinary incontinence?

Answer 1

Pelvic floor muscle training for 3 months

If successful, then advise the woman to continue

If unsuccessful, refer to Gynae for consideration of surgical management

If unsuccessful and the women isn’t a suitable candidate for surgery, or declines, offer Duloxetine

Question 2

What is the management of urge urinary incontinence?

Answer 2

Bladder training for 6 weeks

If symptoms persist:

Offer an anti-muscarinic e.g Oxybutynin

Avoid in elderly patients as crosses the blood brain barrier, and the inhibition of Ach can cause cognitive impairment

Consider Mirabegron (B3 agonist) if anti-muscarinic contraindicated

Question 3

What is the mechanism of action of Oxybutynin?

Answer 3

Anti-muscarinic