Treatment of urinary incontinence in women in general practice: observational studyBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7044.1459 (Published 08 June 1996) Cite this as: BMJ 1996;312:1459
- Arnfinn Seim, general practitioner Bjorn Sivertsen, general practitionera,
- Bjorg Sivertsen,
- Bjarne C Eriksen, consultantb,
- Steinar Hunskaar, professor ()c
- a Medical Office of Health, Rissa, Norway
- b Department of Gynaecology and Obstetrics, Trondheim University Hospital, Trondheim, Norway
- c Division for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
- Correspondence to: Professor S Hunskaar, Division for General Practice, Ulriksdal 8c, N-5009 Bergen, Norway.
- Accepted 25 April 1996
Objective: To examine what is attainable when treating urinary incontinence in women in general practice.
Design: Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice.
Setting: General practice in the rural district of Rissa, Norway.
Subjects: 105 women aged 20 or more with urinary incontinence.
Interventions: Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads.
Main outcome measures: Subjective and objective measures of urinary incontinence; number of patients referred to a specialist.
Results: After 12 months' follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist.
Conclusions: Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results.
General practitioners can treat urinary inconti- nence fairly simply
Treatment options in this study were pelvic floor exercises, electrostimulation, oestrogen, anti- cholinergic drugs, bladder training, and protective pads
After 12 months' follow up most of the women were cured or much better
Funding Unconditional grants were given by the Norwegian Medical Association's Fund for Quality Improvement in Primary Health Care (AS), Saba Malnlycke (for the pad test kits), and Organon (SH).
Conflict of interest None.
- Accepted 25 April 1996