New Guidelines for Urinary Incontinence Screenings

New guidelines now recommend yearly urinary incontinence screening for all women.

But some experts say such screening needs to be introduced with caution.

Urinary incontinence (loss of bladder control) affects about 51 percent of women and can harm their physical, functional and social well-being, according to the American College of Physicians. But many women are reluctant to discuss urinary incontinence with their health care providers, and the condition is often overlooked.

The new guidelines from the Women's Preventive Services Initiative (WPSI) call for annual screening to determine if a woman has urinary incontinence and whether it affects her daily activities and quality of life.

If treatment is warranted, the patient should be referred for further evaluation, according to the guidelines. They were published Aug. 13 in the journal Annals of Internal Medicine.

An accompanying review by Oregon Health and Science University researchers of published studies on urinary incontinence screening found that none of the studies evaluated the overall effectiveness or harms of screening.

There was limited evidence that when used by primary care doctors, screening with short questionnaires is fairly accurate in identifying symptoms of urinary incontinence, the review found.

Despite the lack of direct evidence, the WPSI said screening has the potential to identify urinary incontinence in many women who keep silent about the condition, and noted that early treatment may prevent worsening symptoms, improve quality of life, and reduce the chances of more complex and costly treatment.

In an accompanying editorial, experts at the Women's Health Research Program at Monash University in Melbourne, Australia, wrote that implementing this type of screening is a very serious responsibility and should be introduced with caution.

They said a randomized trial to assess the benefits and harms of urinary incontinence screening is needed before it is introduced for all women.

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