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.
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.