Women with urinary incontinence should be referred to a specialist

BMJ 1996;313:754 (21 September)

Letters

Women with urinary incontinence should be referred to a specialist

EDITOR,--Arnfinn Seim and colleagues give some useful remindersabout improvements that can be achieved by treating urinaryincontinence in women in general practice.¹ At the end of theirstudy, however, 80% of the women were still incontinent to someextent. It is interesting that only 16% of the patients werereferred for specialist opinion. In the long term it may bebetter for patients to be referred for expert diagnosis andtreatment, to avoid some of the long term financial and socialburdens of prolonged incontinence.² When the prospect is manyyears of incontinence (the youngest patient was only 20 yearsold) a referral to a specialist--who can perform urodynamictests, make an accurate diagnosis, and devise a management plan--ispreferable to making an unsupported diagnosis and providingtreatment that may be inappropriate. Obtaining a good clinicalhistory of bladder disorders is known to be difficult, so iftreatment is . . . [Full text of this article]

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Relevant Article

Treatment of urinary incontinence in women in general practice: observational study: Arnfinn Seim, Bjorg Sivertsen, Bjarne C Eriksen, and Steinar Hunskaar
BMJ 1996 312: 1459-1462. [Abstract] [Full Text]