Korean J Fam Pract 2020; 10(4): 248-255  https://doi.org/10.21215/kjfp.2020.10.4.248
Urinary Incontinence and Dysfunction in Primary Care
Ye Seul Yang, Young-Sang Kim*
Department of Family Medicine, CHA Bundang Medical Center, Seongnam, Korea
Young-Sang Kim
Tel: +82-31-780-5360, Fax: +82-31-780-5944
E-mail: zeroup@cha.ac.kr
ORCID: http://orcid.org/0000-0002-7397-5410
Received: April 17, 2020; Accepted: May 16, 2020; Published online: August 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Urinary disorders are important factors that affect the quality of life. Urinary incontinence refers to urine leakage against will and is categorized into stress incontinence, urge incontinence, and other types. The prevalence of incontinence increases with aging. Since most patients hesitate talking about urinary problems, it is important to proactively ask questions to ensure proper care. The diagnostic approach includes history taking, physical examination, and urinalysis. The use of specific questionnaires and voiding diaries is also beneficial. The first management option for patients with incontinence is conservative treatment, especially training for strengthening the pelvic floor muscles. Anti-cholinergic medications and mirabegron are used for treating urge incontinence. To minimize adverse events, starting medications at low doses, with follow-up at short intervals, is recommended. For treating stress incontinence, surgical approaches like sling surgery are preferred to medications. Primary physicians need to pay attention to urinary problems to help older patients address their difficulties and to promote their quality of life.
Keywords: Urinary Incontinence; Urinary Incontinence, Stress; Urinary Incontinence, Urge; Prostatic Hyperplasia
References
  1. Lawhorne LW, Ouslander JG, Parmelee PA, Resnick B, Calabrese B. Urinary incontinence: a neglected geriatric syndrome in nursing facilities. J Am Med Dir Assoc 2008; 9: 29-35.
    Pubmed CrossRef
  2. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21: 167-78.
    Pubmed CrossRef
  3. Chughtai B, Forde JC, Thomas DD, Laor L, Hossack T, Woo HH, et al. Benign prostatic hyperplasia. Nat Rev Dis Primers 2016; 2: 16031.
    Pubmed CrossRef
  4. Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci 2008; 9: 453-66.
    Pubmed KoreaMed CrossRef
  5. Cameron AP, Heidelbaugh JJ, Jimbo M. Diagnosis and office-based treatment of urinary incontinence in adults. Part one: diagnosis and testing. Ther Adv Urol 2013; 5: 181-7.
    Pubmed KoreaMed CrossRef
  6. Jung HB, Kim HJ, Cho ST. A current perspective on geriatric lower urinary tract dysfunction. Korean J Urol 2015; 56: 266-75.
    Pubmed KoreaMed CrossRef
  7. Oh SJ, Park WH, Park CH, Paick JS, Seo JT, Lee YS, et al. Prevalence of urinary incontinence and incontinence-related quality of life in Korean women:a population-based study. J Korean Cont Soc 2003; 7: 73-80.
    CrossRef
  8. Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician 2013; 87: 543-50.
  9. Bradley CS, Rahn DD, Nygaard IE, Barber MD, Nager CW, Kenton KS, et al. The questionnaire for urinary incontinence diagnosis (QUID): validity and responsiveness to change in women undergoing non-surgical therapies for treatment of stress predominant urinary incontinence. Neurourol Urodyn 2010; 29: 727-34.
    Pubmed KoreaMed CrossRef
  10. The Korean Prostate Society. Clinical guidelines of benign prostatic hyperplasia. Seoul: Medrang; 2010.
  11. Newman DK, Cardozo L, Sievert KD. Preventing urinary incontinence in women. Curr Opin Obstet Gynecol 2013; 25: 388-94.
    Pubmed CrossRef
  12. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary incontinence in women: a review. JAMA 2017; 318: 1592-604.
    Pubmed CrossRef
  13. Cameron AP, Jimbo M, Heidelbaugh JJ. Diagnosis and office-based treatment of urinary incontinence in adults. Part two: treatment. Ther Adv Urol 2013; 5: 189-200.
    Pubmed KoreaMed CrossRef
  14. European Association of Urology. Guidelines for urinary incontinence. Arnhem: European Association of Urology; 2018.
  15. Hersh L, Salzman B. Clinical management of urinary incontinence in women. Am Fam Physician 2013; 87: 634-40.
  16. Malhotra B, Gandelman K, Sachse R, Wood N, Michel MC. The design and development of fesoterodine as a prodrug of 5-hydroxymethyl tolterodine (5-HMT), the active metabolite of tolterodine. Curr Med Chem 2009; 16:4481-9.
    Pubmed CrossRef
  17. Kwon HA, Kim HJ, Seo YJ, OH SJ, Lee KC, Lee SH, et al. Clinical guideline on overactive bladder. 3rd ed. Seoul: Korean continence society; 2016.
  18. Kim HJ, Kim TH, Moon KH, Yeo JK, Lee KC, Lee SH, et al. Clinical guideline on overactive bladder. 2nd ed. Seoul: Korean continence society; 2011.
  19. Wood LN, Anger JT. Urinary incontinence in women. BMJ 2014; 349:g4531.
    Pubmed CrossRef
  20. Choi JB. Urinary incontinence in women. Korean J Fam Med 2010; 31: 66171.
    CrossRef


This Article

e-submission

Archives