Practice Guidelines

Urinary Incontinence: Screening Recommendation from the WPSI


Am Fam Physician. 2019 Feb 1;99(3):194.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

•The WPSI recommends screening women for urinary incontinence annually based on low-quality evidence.

•Women with a positive screening result should be referred for further evaluation and treatment.

From the AFP Editors

Editor's Note: This recommendation to screen women for urinary incontinence belies the lack of evidence supporting its benefit. Only a thin logical thread exists, based on indirect evidence, linking early identification to any possible benefit in women not expressing concern. There is little consideration of the harms of early identification, such as labeling and exposure to the risks of further tests and possible treatments. The accuracy of current screening tools is low, and there is no research pointing to benefit of screening on health, function, or quality of life.—Allen F. Shaughnessy, PharmD, AFP Assistant Medical Editor

Urinary incontinence adversely affects health, quality of life, and function for most women at some point in their lives. However, it is underreported because of embarrassment, stigma, or acceptance as normal. Early intervention may reduce progression, improve quality of life, and limit the need for complex and costly treatment.

The Women's Preventive Services Initiative (WPSI) is a national coalition of 21 health professional organizations and patient representatives. It is supported by the Health Resources and Ser vices Administration (HRSA) with the intention to guide coverage of services for HRSA and other stakeholders. The WPSI develops, reviews, updates, and disseminates clinical recommendations for women's preventive health care services, focusing on gaps in current recommendations. Cost is not part of the evaluation. The WPSI performed a systematic review addressing the effectiveness of screening for urinary incontinence for improving symptoms, quality of life, and function, and the accuracy and adverse effects of screening methods. No studies were identified that directly evaluated the effec

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of Practice Guidelines published in AFP is available at



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