For Physicians. By Physicians.™
For Physicians. By Physicians.™
The Women’s Preventive Services Initiative (WSPI), is a US coalition of 21 professional organizations, supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) and led by ACOG. WSPI released guidelines (August 2018) supporting standardized screening for urinary incontinence. (Screening tools can be found in studies listed in ‘Learn More – Primary Sources’ below)
The WPSI recommends screening women for urinary incontinence annually. Screening ideally should assess whether women experience urinary incontinence and whether it affects their activities and quality of life. The WPSI recommends referring women for further evaluation and treatment if indicated. (weak-level recommendation on the basis of the American College of Physicians guideline grading system)
Screening should include the use of validated assessment instruments that include questions about whether a woman has symptoms of urinary incontinence; the type and degree of incontinence; and how symptoms affect her health, function, and quality of life.
Several brief clinician- or self-administered questionnaires for primary care settings identify women with stress, urge, or mixed incontinence and may be used to guide diagnostic evaluations and management.
History
Urinalysis
Physical exam
Cough Stress test
Assess urethral mobility
Postvoid Residual urine volume
Urgency incontinence, also referred to as overactive bladder (OAB) should be considered when urinary urgency is associated with frequency and nocturia. Mixed incontinence is suggested by a combination of involuntary loss of urine associated with both (1) urgency and (2) with physical exertion, sneezing or coughing. Overflow incontinence can occur with chronic urinary retention whether neurologic or iatrogenic. Treatment options vary by incontinence type.
Validation of an overactive bladder awareness tool for use in primary care settings
Validation of a 3-item OAB awareness tool
ACOG & AUGS Practice Bulletin 155: Urinary Incontinence in Women
Pelvic Organ Prolapse Quantification System (POP–Q) – a New Era in Pelvic Prolapse Staging
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