The standardisation of terminology of lower urinary tract function: Report from the standardistation sub-committee of the International Continence Society.

The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.

The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.

The detection of psychiatric illness by questionnaire

http://2015.iuga.org/wp-content/uploads/workshops/ws15_rbump.pdf

The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction

Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence.

Objective To investigate the efficacy of perineal ultrasonography in the assessment of vaginal prolapse.

Perineal video-ultrasonography in the assessment of vaginal prolapse:ealry observations

Urinary incontinence is defined by the International Continence Society as an involuntary loss of urine that is objectively shown and a social and hygiene problem.1 Urinary incontinence not only causes considerable personal discomfort but is also of economic importance to the NHS, costing around £424m per annum.2 In a survey of 10 226 adults aged over 40, the prevalence of incontinence in women was reported as 20.2%.3

Table ​Table11 summarises the prevalence of urinary incontinence from a variety of studies.4 It is likely that about 3 million people are regularly incontinent in the United Kingdom, a prevalence of around 40 per 1000 adults.5



Table 1

Prevalence of urinary incontinence 




Incontinence can be broadly divided into genuine stress incontinence and an overactive bladder (detrusor instability) (fig ​(fig1).1). Bladder symptoms often do not correlate with the underlying diagnosis. Thus urge incontinence often but not always results from an overactive bladder. Emphasis must be placed on the management of urinary incontinence in primary care, as this is effective in both the short term and the long term and benefits secondary care by ensuring that only patients who cannot be managed in primary care are referred.6,7 Urodynamic studies can be reserved for when conservative treatment has failed, surgery is intended, there are voiding difficulties, or a neuropathy is present. 


Summary points


Urinary incontinence affects 20% of women over the age of 40


It affects the quality of life and causes a financial burden to the NHS


Emphasis must be placed on primary health care as many patients can be managed at this level, thus ensuring appropriate referral to hospital


The main causes of urinary incontinence are urethral sphincter incompetence and an overactive bladder


Urodynamic studies are reserved for when conservative treatment has failed, surgery is intended, or voiding difficulties or neuropathy is present









Figure 1

Classification of incontinence

Regular review: management of urinary incontinence in women.

The surgical management of vaginal vault prolapse.

Triple compartment prolapse: sacrocolpopexy with anterior and posterior mesh extensions

26 patients with frequency, urgency and urgency incontinence, without bladder or urethral abnormality, underwent psychiatric evaluation. They were divided into 2 groups according to the degree of neuroticism found. Treatment by group and individual psychotherapy showed that approximately one-third of the patients benefited considerably, one-third refused treatment or ceased prematurely and one-third improved slightly or not at all. The importance of excluding organic bladder or urethral disease prior to psychiatric assessment is stressed.

Stuart L. Stanton

Papers

Perineal video-ultrasonography in the assessment of vaginal prolapse:ealry observations

Regular review: management of urinary incontinence in women.

The surgical management of vaginal vault prolapse.

Triple compartment prolapse: sacrocolpopexy with anterior and posterior mesh extensions

A Psychiatric Study of Women with Urgency and Urgency Incontinence