Treatment Plan

Treatment Plan

Conservative measures:

• Reduce caffeine intake
• Reduce alcohol consumption
• Smoking cessation
• Weight loss if BMI >30

Stress incontinence:

• Supervised pelvic floor exercises (3 months)
• Consider duloxetine if surgery is declined
• Surgical options if conservative management fails

Urge incontinence:

• Bladder training (6 weeks)
• Antimuscarinics: oxybutynin, tolterodine
• Consider mirabegron in the elderly
• Intravaginal oestrogen for postmenopausal women without vaginal atrophy
• Botulinum toxin injections via secondary care if oral antimuscarinics are ineffective

Prognosis

• Can significantly impact the quality of life
• Complications: psychosocial impact, sexual dysfunction, sleep disturbance, falls risk