Assessment, diagnosis and treatment of urinary incontinence in women.

This article gives an overview of female urinary incontinence including the symptoms, diagnosis and treatment of stress urinary incontinence and overactive bladder syndrome. It summarises recent guidelines, the role of the nurse in conservative management and when a referral for specialist care is required. It aims to encourage nurses to use all opportunities to identify women who have urinary incontinence then to assess and treat urinary incontinence effectively. All patients should receive a full continence assessment. National Institute for Health and Care Excellence guidelines recommend conservative treatments including lifestyle advice, pelvic floor exercises and bladder retraining. Nurses may need to access training from their local specialist continence nurse service to enable them to provide evidence-based care. This article concludes that equitable, integrated continence services are essential to improve the quality of care for people with continence problems.

Vaginal oestrogen for overactive bladder in post-menopausal women.

This article asks the question 'Should nurses recommend vaginal oestrogen for overactive bladder in post-menopausal women?' The article will review the evidence for use of vaginal oestrogen and consider the potential side-effects and risks. The main finding is that vaginal oestrogen is effective for treatment of overactive bladder in post-menopausal women with vaginal atrophy. However, vaginal atrophy is undertreated. This article identifies some of the barriers that may prevent diagnosis and treatment, and suggests changes in practice. Nurses should take the initiative and ask post-menopausal women about symptoms. Nurses should be trained to examine women, diagnose vaginal atrophy and discuss treatment.