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NICE: New guidelines for urinary incontinence

New methods of managing urinary incontinence - including drug treatments and surgery - have been highlighted by the National Institute for Care and Health Excellence (NICE) as best practice. 

Urinary incontinence affects an estimated five million women in the UK aged over 20. 

The guidelines have been updated to include the use of antimuscarinic drugs as a first line treatment. 

And where women with proven overactive bladder syndrome have not responded to conservative treatment they should be offered bladder wall injections with Botulinum toxin after discussing the risks and benefits. 

If conservative treatment has failed, women should be offered a procedure using synthetic mid-urethral tape. 

Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: “Urinary incontinence is a distressing condition affecting the lives of millions of women of all ages. While rarely life-threatening, it may seriously influence a woman's physical, psychological and social wellbeing. 

“Over the years we have seen an increase in women seeking treatment, yet many others are still suffering in silence and not receiving the appropriate care for their condition. These new recommendations will sit alongside the original 2006 guideline to provide women with high quality up-to-date care and support.”

Types of urinary incontinence (UI) include:

 - Stress UI - involuntary urine leakage on effort or exertion or on sneezing, coughing or laughing.

 - Urge UI - involuntary urine leakage accompanied or immediately preceded by urgency.

 - Mixed UI - involuntary urine leakage associated by both exertion and urgency.

 - Overactive bladder syndrome (OAB) - Urgency that occurs with or without urge UI and usually with frequency.