Urinary Incontinence
Initial Primary Care Assessment:
IdentifyStress incontinence/Overactive bladder (OAB) and urge incontinence/mixed
· Consider using the Bladder Symptom Profile and Bladder Diary in the link here
Do urinalysis
Consider and treat
· UTI/pelvic mass/neurological problems/medication effect/constipation/atrophic vaginitis/obesity/fluid intake/chronic cough.
Arrange a bladder voiding ultrasound scan if
· voiding dysfunction (see Link to Definitions of OAB, Stress Incontinence and Voiding Dysfunction)
· or recurrent UTI
Red flags
· a/ Micro (50yrs+) & macro haematuria – 2ww urology referral
· b/ Recurrent UTI with haematuria (40yrs+)- 2ww referral urology
· c/ Suspected pelvic mass; refer to gynae outpatient if benign, or 2ww gynae if suspected as malignant mass
· d/ Consider red flags in these circumstances too:
· Persisting bladder/urethral pain
· New faecal incontinence or constipation
· Suspected local neurology
· Voiding difficulty
· Urogenital fistulae
· Previous continence or pelvic cancer surgery or previous pelvic radiation therapy
Link to Algorithm for management of Female Urinary Incontinence
Link to Urodynamic Studies, Bladder Diaries, Pelvic Floor Nurses
NOTE:
· bladderandbowelspecialistenquiries@nhs.net and 01726 873095
· The Bowel and Bladder services (BBSS) will also see patients where there is diagnostic uncertainty