New Guideline for Occasional Incontinence Treatment from the American College of Physicians
New Guidelines for Occasional Incontinence Treatment from the American College of Physicians
The American College of Physicians (ACP) recently released new guideline for occasional incontinence treatment in women. The guidelines, published in the Sept 15, 2015 Annals of Internal Medicine Journal, concluded that incontinence drugs are not effective treatments for most women. According to Dr. David Fleming, president of the ACP, “Physicians should utilize non-drug treatments as much as possible for occasional urinary incontinence.”
Occasional urinary incontinence is a concern for 44-57% of women age 40-60 and 75% of women age 75 and older. It can cause embarrassment, and distress, and many women do not report it, according to the ACP. The ACP guidelines addressed each of the various forms of urinary incontinence separately.
For occasional stress urinary incontinence, which occurs when urine is leaked during coughing, sneezing, laughing or exercising, the ACP recommends Kegel exercises to develop the muscles that support the pelvic floor: the bladder, uterus, vagina and rectum muscles.
Strengthening the muscles that enable you to stop urine mid-stream was recommended as the most appropriate first line therapy as it was seen to be 5 times more effective than undergoing no treatment at all. Drug therapy was not deemed effective for sufferers of occasional stress incontinence, according to the ACP, and is not recommended.
For women who experience occasional urge incontinence, in which they experience a need to urinate but cannot make it to the restroom on time, the ACP recommends bladder training or teaching the bladder to urinate on a schedule. Drug treatments are only suggested as a possible treatment option if bladder training does not work as the side effects, including insomnia, dizziness, headaches, blurry vision, dry mouth and constipation are often severe enough for patients to opt to discontinue the medication.
For women who suffer from a combination of both occasional stress and urge incontinence, the ACP recommends a combination of kegels and bladder training. Women who are overweight are also encouraged to lose weight and begin exercise programs as part of their treatment.
The ACP further addresses physicians, charging them with being more proactive in discussing bladder concerns with patients. As Dr. Fleming states, “Occasional urinary incontinence is a common problem for women that is often under-reported and under-diagnosed… Physicians should take an active approach and ask specific questions” in order to better identify and treat occasional incontinence concerns.
In summary, non-drug treatments should be utilized as the first line of defense for treating occasional urinary incontinence.
Read Related Articles: Blog, Overactive Bladder (OAB), Incontinence