Jennifer Wu, MD, MPH, penned a feature published in today’s issue of the New England Journal of Medicine providing clinical guidance for treating stress incontinence in women.
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Jennifer Wu, MD, MPH, professor in the UNC Department of Obstetrics and Gynecology and interim Vice Dean of Academic Affairs for the UNC School of Medicine, is the author of a New England Journal of Medicine feature titled, “Stress Incontinence in Women,” that was published in the June 24, 2021 Issue.
The article begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines. The article ends with Wu’s clinical recommendations.
Key clinical points in the article include:
- Stress incontinence is common among women, yet less than 40% of affected women seek care.
- Screening can be easily achieved by asking women if they have urinary leakage with coughing, laughing, sneezing, or exercise.
- Exercises that strengthen the pelvic-floor muscles are effective in controlling stress incontinence, and weight loss is recommended in overweight or obese women.
- Referral to a specialist for an incontinence pessary or surgery should be considered if behavioral therapy options have failed and the patient continues to have bothersome symptoms.
- Surgery is the most effective option; shared decision making should entail a detailed discussion of the risks and benefits of different surgical procedures.
- The most commonly performed surgery is placement of a midurethral mesh sling, a minimally invasive, outpatient, 30-minute procedure with high efficacy and a relatively low rate of complications.
Click here to see the full article.