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General Practice

Treatment of urinary incontinence in women in general practice: observational study

BMJ 1996; 312 doi: (Published 08 June 1996) Cite this as: BMJ 1996;312:1459
  1. Arnfinn Seim, general practitioner Bjorn Sivertsen, general practitionera,
  2. Bjorg Sivertsen,
  3. Bjarne C Eriksen, consultantb,
  4. Steinar Hunskaar, professor (steinar.hunskar{at}
  1. a Medical Office of Health, Rissa, Norway
  2. b Department of Gynaecology and Obstetrics, Trondheim University Hospital, Trondheim, Norway
  3. c Division for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
  1. 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.

Key messages

  • 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
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