Urine incontinence referral criteria for primary care

Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Espanola de Medicos de Atencion Primaria [SEMERGEN], Sociedad Espanola de Medicos Generales y de Familia [SEMG], Sociedad Espanola de Medicina de Familia y Comunitaria [semFYC]) along with the Asociacion Espanola de Urologia (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women >40 years old and asymptomatic men >55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen. (C) 2013 Elsevier Espana, S.L. All rights reserved.