Urinary incontinence. Screening and treatment of urinary dysfunction.

Most of the 13 million Americans who have urinary incontinence are adults, and a significant number are never treated. Undertreatment is due in part to reluctance by patients and physicians to discuss an uncomfortable topic. Unmanaged incontinence restricts normal daily activity and fundamental human interactions. Intervention is important not only to control symptoms, prevent infection, and impede incontinence progression, but also to restore quality of life. In most cases, the physical exam and patient history provide the necessary information for diagnosis. Behavioral treatments are easy to implement and inexpensive, although patient nonadherence can undermine effectiveness.