Clinical Practice Guideline

Urinary Incontinence in Women

Nonsurgical Management of Urinary Incontinence in Women

(Endorsed, May 2015)

The guideline, Nonsurgical Management of Urinary Incontienence in Women, was developed by the American College of Physicians and was endorsed by the American Academy of Family Physicians.

Key Recommendations

  • Pelvic floor muscle training should be first-line treatment for women with stress urinary incontinence (UI).
  • Bladder training should be first-line treatment for women with urgency UI.
  • Women with mixed UI should be treated with pelvic floor training combined with bladder training.
  • Systemic pharmacologic therapy should not be prescribed for stress UI.
  • Pharmacologic treatment should be prescribed to women with urgency UI if bladder training was unsuccessful. Choice of pharmacologic agent should be based on tolerability, adverse effect profile, ease of use, and cost.
  • Weight loss and exercise should be recommended for obese women with UI.

See the full recommendation for further details.

These guidelines are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute the individual judgment brought to each clinical situation by the patient’s family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These guidelines are only one element in the complex process of improving the health of America. To be effective, the guidelines must be implemented.