Abstract
BACKGROUND: Several reports have been published showing that women with urinary incontinence (UI) can be taken care of and treated satisfactorily in general practice. AIM: To find out whether the treatment of women with UI in general practice is effective also in the long term. METHOD: One hundred and five women with UI who consulted their general practitioner (GP) were examined and treated according to a treatment protocol. Treatment options were pelvic floor exercises, electrical stimulation, oestrogen supplements, bladder training, and protective pads. Three to six years after inclusion, all women received a postal questionnaire to evaluate the long-term effectiveness of treatment. Women who had been referred to a specialist were excluded. RESULTS: Eighty out of 82 eligible patients answered the questionnaire after a mean follow-up period of 56 months. Twenty-seven per cent were continent, 26% much better, 23% a little better, 21% unchanged, and 3% were worse compared with before the treatment. The median score on a 100 mm visual analogue scale was 16 compared with 31 before treatment, and the percentage of women that were 'much' or 'a great deal' bothered by UI was reduced from 35% to 12%. The percentage of women with severe UI was reduced from 59% to 30%, and the number of women using pads was reduced from 62% to 39%. CONCLUSION: This study confirms that management of female UI in general practice is effective also in the long term.
Full Text
The Full Text of this article is available as a PDF (30.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alcalay M., Monga A., Stanton S. L. Burch colposuspension: a 10-20 year follow up. Br J Obstet Gynaecol. 1995 Sep;102(9):740–745. doi: 10.1111/j.1471-0528.1995.tb11434.x. [DOI] [PubMed] [Google Scholar]
- Black N. A., Downs S. H. The effectiveness of surgery for stress incontinence in women: a systematic review. Br J Urol. 1996 Oct;78(4):497–510. doi: 10.1046/j.1464-410x.1996.01422.x. [DOI] [PubMed] [Google Scholar]
- Burgio K. L., Matthews K. A., Engel B. T. Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women. J Urol. 1991 Nov;146(5):1255–1259. doi: 10.1016/s0022-5347(17)38063-1. [DOI] [PubMed] [Google Scholar]
- Bø K., Talseth T. Long-term effect of pelvic floor muscle exercise 5 years after cessation of organized training. Obstet Gynecol. 1996 Feb;87(2):261–265. doi: 10.1016/0029-7844(95)60375-1. [DOI] [PubMed] [Google Scholar]
- Eriksen B. C., Eik-Nes S. H. Long-term electrostimulation of the pelvic floor: primary therapy in female stress incontinence? Urol Int. 1989;44(2):90–95. doi: 10.1159/000281478. [DOI] [PubMed] [Google Scholar]
- Eriksen B. C., Hagen B., Eik-Nes S. H., Molne K., Mjølnerød O. K., Romslo I. Long-term effectiveness of the Burch colposuspension in female urinary stress incontinence. Acta Obstet Gynecol Scand. 1990;69(1):45–50. doi: 10.3109/00016349009021038. [DOI] [PubMed] [Google Scholar]
- Fall M., Frankenberg S., Frisén M., Larsson B., Petrén M. 456 000 svenskar kan ha urininkontinens. Endast var fjärde söker hjälp för besvären. Lakartidningen. 1985 May 29;82(22):2054–2056. [PubMed] [Google Scholar]
- Hahn I., Milsom I., Fall M., Ekelund P. Long-term results of pelvic floor training in female stress urinary incontinence. Br J Urol. 1993 Oct;72(4):421–427. doi: 10.1111/j.1464-410x.1993.tb16170.x. [DOI] [PubMed] [Google Scholar]
- Jolleys J. V. Diagnosis and management of female urinary incontinence in general practice. J R Coll Gen Pract. 1989 Jul;39(324):277–279. [PMC free article] [PubMed] [Google Scholar]
- Korman H. J., Sirls L. T., Kirkemo A. K. Success rate of modified Pereyra bladder neck suspension determined by outcomes analysis. J Urol. 1994 Nov;152(5 Pt 1):1453–1457. doi: 10.1016/s0022-5347(17)32443-6. [DOI] [PubMed] [Google Scholar]
- Lagro-Janssen A. L., Debruyne F. M., Smits A. J., van Weel C. The effects of treatment of urinary incontinence in general practice. Fam Pract. 1992 Sep;9(3):284–289. doi: 10.1093/fampra/9.3.284. [DOI] [PubMed] [Google Scholar]
- O'Brien J., Austin M., Sethi P., O'Boyle P. Urinary incontinence: prevalence, need for treatment, and effectiveness of intervention by nurse. BMJ. 1991 Nov 23;303(6813):1308–1312. doi: 10.1136/bmj.303.6813.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
- O'Brien J., Long H. Urinary incontinence: long term effectiveness of nursing intervention in primary care. BMJ. 1995 Nov 4;311(7014):1208–1208. doi: 10.1136/bmj.311.7014.1208. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rekers H., Drogendijk A. C., Valkenburg H., Riphagen F. Urinary incontinence in women from 35 to 79 years of age: prevalence and consequences. Eur J Obstet Gynecol Reprod Biol. 1992 Feb 28;43(3):229–234. doi: 10.1016/0028-2243(92)90178-2. [DOI] [PubMed] [Google Scholar]
- Sandvik H., Hunskaar S., Seim A., Hermstad R., Vanvik A., Bratt H. Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey. J Epidemiol Community Health. 1993 Dec;47(6):497–499. doi: 10.1136/jech.47.6.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Seim A., Eriksen B. C., Hunskaar S. A study of female urinary incontinence in general practice. Demography, medical history, and clinical findings. Scand J Urol Nephrol. 1996 Dec;30(6):465–471. doi: 10.3109/00365599609182325. [DOI] [PubMed] [Google Scholar]
- Seim A., Hermstad R., Hunskaar S. Management in general practice significantly reduced psychosocial consequences of female urinary incontinence. Qual Life Res. 1997 Apr;6(3):257–264. doi: 10.1023/a:1026414822573. [DOI] [PubMed] [Google Scholar]
- Seim A., Sandvik H., Hermstad R., Hunskaar S. Female urinary incontinence--consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community. Fam Pract. 1995 Mar;12(1):18–21. doi: 10.1093/fampra/12.1.18. [DOI] [PubMed] [Google Scholar]
- Seim A., Sivertsen B., Eriksen B. C., Hunskaar S. Treatment of urinary incontinence in women in general practice: observational study. BMJ. 1996 Jun 8;312(7044):1459–1462. doi: 10.1136/bmj.312.7044.1459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sirls L. T., Keoleian C. M., Korman H. J., Kirkemo A. K. The effect of study methodology on reported success rates of the modified Pereyra bladder neck suspension. J Urol. 1995 Nov;154(5):1732–1735. [PubMed] [Google Scholar]