ITEMS IN AFP WITH KEYWORD:
The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary incontinence and the effect, if any, on their lives.
Feb 1, 2019 Issue
Urinary Incontinence: Screening Recommendation from the WPSI [Practice Guidelines]
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.
Urinary retention is the inability to voluntarily pass an adequate amount of urine, and it can be acute or chronic in nature. There are various causes of urinary retention, and initial evaluation should include a detailed history and neurologic examination. Diagnostic testing includes measuring postvoid residual urine volume, and management includes catheterization.
Feb 1, 2018 Issue
OnabotulinumtoxinA Injections for Urge Incontinence [FPIN's Help Desk Answers]
Detrusor muscle injections of onabotulinumtoxinA can be used to decrease the number of episodes of urinary incontinence in women for whom treatment with anticholinergic agents has been ineffective.
The American College of Physicians (ACP) has provided recommendations for nonsurgical treatment of UI in women. Treatment of UI is aimed at achieving, or at least improving, symptoms. It is deemed effective if it reduces the number of episodes by at least one-half.
Jan 15, 2015 Issue
Medications for Treatment of Interstitial Cystitis [FPIN's Clinical Inquiries]
There are no long-term clinically effective oral medications. Pentosan (Elmiron) can improve overall symptom scores for interstitial cystitis over three to six months, but it does not improve scores for any of three individual symptoms (dysuria, urgency, frequency) compared with placebo.
Desmopressin is a safe and effective treatment to offer adults with clinically significant nocturia. The initial starting dose should be 50 to 100 mcg, with lower dosing for the advanced older patient. All patients should be monitored for hyponatremia.
Learn which tests should be performed after obtaining abnormal urinalysis results in patients with asymptomatic microscopic hematuria, ureteral stents, or asymptomatic bacteriuria.
This intervention, which included primiparous women with and without urinary incontinence at six weeks post-partum, demonstrated that intensive supervised pelvic floor muscle training did not reduce the prevalence of urinary incontinence at six months. These results are noteworthy because the trial was well designed and the results were unexpected.
Although routine screening for bladder cancer is not recommended, microscopic hematuria is often incidentally discovered by primary care physicians. The American Urological Association has published an updated guideline for the management of asymptomatic microscopic hematuria, which is defined as ...