ITEMS IN AFP WITH KEYWORD:
Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.
Dec 1, 2019 Issue
Pelvic Floor Muscle Training for Treatment of Urinary Incontinence in Women [Medicine by the Numbers]
Urinary incontinence is common in adult women, leading to health complications such as rash and urinary tract infections. This review discusses pelvic floor muscle training for the treatment of urinary incontinence in women.
Urinary incontinence is a common problem in women. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for UI in all women. Initial evaluation should determine whether incontinence is transient or chronic, the subtype of the incontinence, and whether findings warrant subspecialist referral. Urinalysis should be ordered for all patients. Pelvic floor strengthening and lifestyle modifications are first-line recommendations.
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.