Female incontinence: Consultations on new treatments
5th February 2013 – Doctors treating women with urinary incontinence are to be given updated clinical guidelines in the light of new treatment options that have been developed over the past few years.
The National Institute for Health and Clinical Excellence (NICE) has published a draft version of the guidance for public consultation.
Urinary incontinence affects an estimated five million women in England and Wales over the age of 20. Types of incontinence include:
- Stress urinary incontinence – which involves urine leakage on effort or exertion or on sneezing, coughing or laughing
- Urge urinary incontinence – involuntary urine leakage accompanied or immediately preceded by urgency
- Mixed urinary incontinence – involuntary urine leakage associated by both exertion and urgency
- Overactive bladder syndrome (OAB) – where urgency to pass urine occurs with or without urge urinary incontinence, and usually with frequency
NICE says it last published guidance to health professionals on treating urinary incontinence in 2006 but that new developments mean some of the recommendations need updating.
The draft guidance says that women with overactive bladder syndrome or mixed urinary incontinence should be offered immediate release types of antimuscarinic drugs – medications that inhibit certain nerve impulses – as a first line treatment. Examples of these drugs are oxybutynin, tolterodine or propiverine.
In cases where treatment is not successful, patients should be offered trospium, oxybutynin, tolterodine or darifenacin (extended release) as a second line treatment to attempt to control