Managing stress urinary incontinence - a primary care issue

Stress urinary incontinence (SUI) is a common condition in women, caused by anatomical problems related to factors such as age, parity, menopause and obesity. Depending on the clinical findings and on the severity of symptoms, SUI can be managed with conservative methods including pelvic floor exercises, vaginal cones and general lifestyle modification advice; or, it can be treated surgically with procedures such as Burch colposuspension, vaginal slings or tension-free tapes and injection of bulking agents alongside the urethra. SUI is greatly underdiagnosed, because many women are reluctant to consult their doctors about their condition. Department of Health guidelines are placing greater emphasis on primary care management of the condition and Primary Care Trusts (PCTs) to provide consistent, integrated continence care services. The availability of new, non-invasive treatment options, such as duloxetine, are likely to have a positive impact on the future of SUI management.