Paliatívna medicína a liečba bolesti 3/2009

Stress urinary incontinence in postmenopausal women

In the form of summary survey, the author of this report addresses the stress urinary incontinence (SUI) in women. The condition of urinary incontinence (UI) is far more prevalent in women and significant progress in incidence with the increase of age. SUI has multifactorial etiology in most cases of frail older patients. Author briefly reported about epidemiology, (possible) etiology and pathophysiology, diagnosis and therapy of SUI in older women. Contrary to previous belief, menopause per se does not appear to be a risk factor for UI and there is conflicting evidence regarding hysterectomy. The first contact a SUI woman has with healthcare providers should always focus on basic diagnostic tests (assessment of the patient’s history and symptoms, frequency/volume chart and special questionnaires, physical examination, digital rectal/vaginal examination, urinalysis, blood analysis, post void residual urine, uroflowmetry etc.). If an accurate diagnosis of the disease requires further investigation (e. g. complex situations, such as neuropathic bladder), or if the initial treatment has failed, specialized diagnostic management (cystourethroscopy, imaging, urodynamics etc.) may be become necessary. There are discussed all eventualities and perspectives (mostly) of conservative and interventional treatment of SUI in older women.

Keywords: stress urinary incontinence, older woman, epidemiology, diagnosis, therapy.