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. 1998 Feb;48(427):975–977.

General practitioners and women with urinary incontinence.

M Grealish 1, T C O'Dowd 1
PMCID: PMC1409992  PMID: 9624768

Abstract

BACKGROUND: Urinary incontinence is a common problem for adult women. It results in a large financial and psychosocial cost. Much urinary incontinence goes unreported. Women with urinary incontinence can be successfully assessed and treated in general practice but studies have shown that many GPs manage the condition inadequately. AIM: This study aims to examine GPs' awareness of urinary incontinence in women and their management of, and attitudes to, female urinary incontinence. METHOD: A qualitative study was conducted with 21 GPs responding to semi-structured interviews. Thematic analysis was carried out on these interviews, with recurrent views and experiences being identified and grouped. RESULTS: The interviews of 11 male and nine female GPs were suitable for analysis. GPs were aware of the prevalence and under-reporting of urinary incontinence in women. Many were unhappy with their own management of the condition and with the management options available to them. Male GPs in particular were reluctant to carry out gynaecological examinations, and few GPs expressed enthusiasm for teaching pelvic floor exercises or bladder drills. Medications were frequently used but generally considered ineffective or intolerable. The services of both public health nurses and practice nurses were under-used, largely because of lack of training in this area. Although incontinence nurses were employed in the area, many GPs did not know of their availability and, of those who did, few referred to them more than infrequently. CONCLUSION: This study demonstrates that many GPs avoid dealing with the problem of urinary incontinence in women and that they find it to be a difficult, chronic problem to treat. Specialist options seem not to be useful in general practice. The findings need to be explored in other GP settings.

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Selected References

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  1. Ashworth P. D., Hagan M. T. The meaning of incontinence: a qualitative study of non-geriatric urinary incontinence sufferers. J Adv Nurs. 1993 Sep;18(9):1415–1423. doi: 10.1046/j.1365-2648.1993.18091415.x. [DOI] [PubMed] [Google Scholar]
  2. Briggs M., Williams E. S. Urinary incontinence. BMJ. 1992 Jan 25;304(6821):255–255. doi: 10.1136/bmj.304.6821.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brocklehurst J. C. Urinary incontinence in the community--analysis of a MORI poll. BMJ. 1993 Mar 27;306(6881):832–834. doi: 10.1136/bmj.306.6881.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cardozo L. Urinary incontinence in women: have we anything new to offer? BMJ. 1991 Dec 7;303(6815):1453–1457. doi: 10.1136/bmj.303.6815.1453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hall C., Castleden C. M., Grove G. J. Fifty six continence advisers, one peripatetic teacher. BMJ. 1988 Nov 5;297(6657):1181–1182. doi: 10.1136/bmj.297.6657.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harrison G. L., Memel D. S. Urinary incontinence in women: its prevalence and its management in a health promotion clinic. Br J Gen Pract. 1994 Apr;44(381):149–152. [PMC free article] [PubMed] [Google Scholar]
  7. Hilton P., Stanton S. L. Algorithmic method for assessing urinary incontinence in elderly women. Br Med J (Clin Res Ed) 1981 Mar 21;282(6268):940–942. doi: 10.1136/bmj.282.6268.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. 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]
  9. Jolleys J. V. Reported prevalence of urinary incontinence in women in a general practice. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1300–1302. doi: 10.1136/bmj.296.6632.1300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jolleys J. V., Wilson J. V. Urinary incontinence. GPs lack confidence. BMJ. 1993 May 15;306(6888):1344–1344. doi: 10.1136/bmj.306.6888.1344-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. 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]
  12. Lagro-Janssen T. L., Smits A. J., Van Weel C. Women with urinary incontinence: self-perceived worries and general practitioners' knowledge of problem. Br J Gen Pract. 1990 Aug;40(337):331–334. [PMC free article] [PubMed] [Google Scholar]
  13. Norton P. A., MacDonald L. D., Sedgwick P. M., Stanton S. L. Distress and delay associated with urinary incontinence, frequency, and urgency in women. BMJ. 1988 Nov 5;297(6657):1187–1189. doi: 10.1136/bmj.297.6657.1187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. 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]
  15. Thomas T. M., Plymat K. R., Blannin J., Meade T. W. Prevalence of urinary incontinence. Br Med J. 1980 Nov 8;281(6250):1243–1245. doi: 10.1136/bmj.281.6250.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Thomas T. M., Plymat K. R., Blannin J., Meade T. W. Prevalence of urinary incontinence. Br Med J. 1980 Nov 8;281(6250):1243–1245. doi: 10.1136/bmj.281.6250.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]

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