Treatment options for female urinary incontinence.

Contrary to the belief of some patients and physicians, urinary incontinence in women should not be accepted as a natural and inevitable part of aging. Indeed, it is a costly problem, psychologically, physically, and economically, and can have a considerable impact on a woman's quality of life. Accurate diagnosis of the type of incontinence is important to implement appropriate and successful treatment. In general, a focused medical and symptom-oriented history and physical examination is all that is needed to establish the correct diagnosis. UI, SUI, and mixed incontinence are the most common types seen in women. Most patients with urge incontinence respond to behavioral treatments, PFEs, medication, or some combination thereof. Recalcitrant cases should be referred to a specialist. Patients with SUI may respond to PFEs, but many require surgical intervention for a satisfactory outcome. The successful treatment of urinary incontinence in a woman can lead to a substantial improvement in her overall quality of life, and for the physician, can be as professionally rewarding as the successful management of various other chronic disease states.