ROYAL HAMPSHIRE COUNTY HOSPITAL, WINCHESTER FEMALE URINARY INCONTINENCE KEY GP – History & examination – assess severity & impact on QoL (see overleaf) - Qol: quality of life Urinalysis (MSU if wbc/nitrites): Rx UTI only if +ve culture Advise Ð caffeine intake, lose wt, & stop smoking Advise voiding diary for at least 3 days. – local E2 if atrophic LGT Consider initiating anticholinergics e.g Detrusitol, Vesicare, Kentera, Oxybutynin, Darifenacin, Toviaz if OAB is suspected (as well as referral to Continence Advisor). OAB: overactive bladder LGT: lower genital tract E2: Oestradiol PFE: pelvic floor exercise Mixed urinary incontinence Stress incontinence Physiotherapy: - PFE – for 3mths - electrical stimulation - biofeedback Refer to physiotherapist or continence advisor as determined by dominant symptom i.e either stress or urge incontinence. Urge incontinence/OAB Refer to Hospital if: Continence advisor: - bladder retraining - review fluid intake - if no improvement after 6/52 Îconsider anticholinergics drugs (see above) a) UROLOGY; Haematuria-macroscopic - microscopic if >50yr Voiding dysfunction Recurrent UTI Bladder pain b) UROGYNAECOLOGY Pelvic mass Symptomatic prolapse Voiding dysfunction Symptomatic improvement No improvement Discharge to GP Symptomatic improvement Refer to Urology or Urogynaecology Discharge to GP No improvement Refer to Urology or Urogynaecology Consultants: Mr O L Olujide (Urogynaecology), Mr A Adamson (Urology); Women’ Health Physiotherapy team – Tel 01962 824917/01264 835266, Fax: 01962 824916; Urodynamics Specialist Sister(urology): Tina Gehring; Gynaecology Nurse: Denise Cox
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