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Chapter 27 - Urinary Incontinence

from Section 5 - Post-Reproductive Care

Published online by Cambridge University Press:  24 November 2021

Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Urinary incontinence is a common condition in women. All cases require a basic assessment, while urodynamic studies are indicated in those with complex or refractory symptoms. Initial treatment includes lifestyle advice, behavioural modifications, bladder retraining and pelvic floor muscle training. Synthetic mid-urethral sling procedures have revolutionized stress incontinence surgery and reduced the popularity of ‘traditional’ procedures, such as colposuspensions and pubovaginal slings. With regard to urgency urinary incontinence, antimuscarinic agents are the mainstay of current medical management, while a selective β3-adrenergic receptor agonist (Mirabegron) offers an alternative pharmacological option. Intravesical botulinum toxin and neuromodulation (peripheral or sacral) are available to women with refractory symptoms

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Publisher: Cambridge University Press
Print publication year: 2021

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