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

Link to Definitions and Tips

 

NOTE:

·         bladderandbowelspecialistenquiries@nhs.net and 01726 873095

·         The Bowel and Bladder services (BBSS) will also see patients where there is diagnostic uncertainty