The American College of Physicians (ACP) has presented evidence and provided clinical recommendations for the nonsurgical management of urinary incontinence (UI) in women. The clinical practice guideline has been published in the Sept. 16 issue of the Annals of Internal Medicine.
Amir Qaseem, M.D., Ph.D., of the ACP in Philadelphia, and colleagues reviewed literature from 1990 through December 2013 to grade evidence and recommendations for the nonsurgical management of UI in women.
The researchers found evidence to support six strong recommendations for the management of UI in women. For stress UI, first-line treatment with pelvic floor muscle training (high-quality evidence) is recommended. Systemic pharmacologic therapy is not recommended for stress UI (low-quality evidence).
For urgency UI, bladder training (moderate-quality evidence) is recommended; pharmacologic treatment is advised if bladder training fails (high-quality evidence). For mixed UI, pelvic floor muscle training (moderate-quality evidence) is recommended. For obese women with UI, weight loss and exercise (moderate-quality evidence) are recommended.
“Urinary incontinence is a common and important health care problem in women that is underreported and underdiagnosed,” the authors write.
Several authors disclosed financial ties to pharmaceutical and biomedical companies