Urinary Incontinence in Adults: Acute and Chronic Management: 1996 Update

Despite the prevalence of urinary incontinence (UI), the condition is widely underdiagnosed and underreported. Many health care providers remain uneducated about this condition, and individuals are often ashamed or embarrassed to seek professional help. Furthermore, UI diagnostic and treatment practices as well as associated medical costs vary widely. These factors prompted the selection of UI in adults as a topic for guideline development. A panel of experts used an extensive review of scientific literature as well as expert judgment and group consensus to develop this guideline. Findings and recommendations are presented for (1) prevention, identification, and evaluation of UI; (2) use of behavioral, pharmacologic, and surgical treatment as well as supportive devices; (3) long-term management of chronic intractable UI; and (4) education of health professionals and the public. The panel found evidence in the literature that the treatment of UI can improve or "cure" most patients. They concluded that all patients with UI should have a basic diagnostic evaluation and that behavioral and pharmacologic therapies are usually reasonable first steps in management. In addition, vigorous efforts should be made to educate the professional and lay public.