Abstract

Urinary incontinence is a common and distressing condition known to adversely affect quality of life. It is widely prevalent and places a considerable financial burden on society.

Stress urinary incontinence describes a symptom or a sign. A diagnosis of urodynamic stress incontinence can only be made following urodynamic investigation. This condition is defined as ‘the involuntary leakage of urine during increased abdominal pressure in the absence of a detrusor contraction. The aetiology of urodynamic stress incontinence is complex and remains poorly understood. There are several options available for the management of SUI: conservative, medical as well as surgical. The initial line of treatment in USI should be conservative, with lifestyle advice and pelvic floor muscle training. Medical management is a relatively new approach in the treatment of stress incontinence and should be considered after behavioural intervention and pelvic floor muscle training has failed and where there are no contra indications to the use of duloxetine. Surgery however remains the mainstay of treatment in women with severe stress incontinence or in those who fail to improve with conservative measures.

The aim of this review is to describe the epidemiology of stress urinary incontinence and consider the various modalities for its conservative management

Keywords: Conservative therapy, duloxetine, estrogen, pelvic floor therapy, pessary, radiofrequency denaturation, stress urinary incontinence, urodynamics stress incontinence.