This article gives an overview of female urinary incontinence including the symptoms, diagnosis and treatment of stress urinary incontinence and overactive bladder syndrome. It summarises recent guidelines, the role of the nurse in conservative management and when a referral for specialist care is required. It aims to encourage nurses to use all opportunities to identify women who have urinary incontinence then to assess and treat urinary incontinence effectively. All patients should receive a full continence assessment. National Institute for Health and Care Excellence guidelines recommend conservative treatments including lifestyle advice, pelvic floor exercises and bladder retraining. Nurses may need to access training from their local specialist continence nurse service to enable them to provide evidence-based care. This article concludes that equitable, integrated continence services are essential to improve the quality of care for people with continence problems.

Assessment, diagnosis and treatment of urinary incontinence in women

Caffeine consumption is highly prevalent in the adult population. First-line treatment of overactive bladder (OAB) symptoms involves behavioral modification, which includes reduction of caffeine consumption. A literature review over the last 3 years has identified 10 peer-reviewed articles that investigated the effects and mechanisms of caffeine on OAB symptoms. The literature describes that caffeine can be associated to de novo OAB symptoms or their exacerbation. Those effects have been found to be dose dependent. Significant associations to age and gender cannot be made at this point due to limited studies. This review raises awareness of caffeine’s potential causal impact on OAB symptoms, which is important when counseling the general population and patients suffering from OAB. Since there is a lack of evidence-based data to support clinical recommendations, more controlled-randomized prospective studies are needed to assess the impact of caffeine on OAB symptoms that also control for dose, gender, and age.

Marie-Claire Longworth

Papers

Modern management of overactive bladder syndrome