No. 397 – Conservative Care of Urinary Incontinence in Women

OBJECTIVE: To outline the evidence for conservative care, including both assessment and management options, for urinary incontinence in women. INTENDED USERS: Relevant primary care providers and medical specialists including but not limited to physicians, nurses, midwives, and pelvic health physiotherapists. TARGET POPULATION: Women (>18 years of age) with urinary incontinence. OPTIONS: Assessment options include gathering of a detailed history, physical examination, laboratory analysis, urodynamic evaluation, and cystoscopy. Conservative management options include lifestyle management, pelvic floor muscle training, behavioural management, and mechanical devices. OUTCOMES: To provide an evaluation-based summary of current available evidence concerning efficacy of conservative care (assessment and management) strategies for urinary incontinence in women. EVIDENCE: The Cochrane Library and Medline (2013-2018) were searched to find articles related to conservative care of urinary incontinence in women (>18 years). Articles were appraised, and the collective evidence was graded. VALIDATION METHODS: The evidence obtained was reviewed and evaluated by the Society of Obstetricians and Gynaecologists of Canada (SOGC) Urogynecology Committee under the leadership of the principal authors. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology framework. BENEFITS, HARMS, AND COSTS: Evidence for the efficacy of conservative care (assessment and management) options for women with urinary incontinence is strong. Furthermore, these options carry minimal or no harm and confer an established cost benefit. GUIDELINE UPDATE: This SOGC Clinical Practice Guideline will be automatically reviewed 5 years after publication. SUMMARY STATEMENTS: RECOMMENDATIONS.