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Aim: The aim was to describe the characteristics of young adult women who report urinary incontinence (UI), the types of UI they experience, the strategies they use or consider important for managing UI, and help-seeking behavior., Methods: Data were from the 1989-1995 Australian Longitudinal Study on Women's Health cohort (n = 8457) at age 22 to 27 (in 2017). Descriptive statistics were used to summarize: characteristics of young women who experience UI; the types of UI they experience; which strategies women use to manage UI; perceptions of bladder control; and the proportion of women who seek help (and reasons why not). Prevalence ratios for UI according to sample characteristics were calculated using Poisson regression models., Results: At age 22 to 27, 11% (n = 986) of young women reported UI in the past month. Compared with women who did not have UI, those reporting UI were 7 kg heavier on average and were more likely to be in the obese body mass index category, report high psychological distress, and have at least one child. Most women with UI reported mixed symptoms of UI (stress and urge), and used a combination of strategies to self-manage UI symptoms. Only one in five women had sought help or advice from a healthcare professional., Conclusions: Obesity, parity, and high psychological distress are strong correlates of UI in young women. As the majority of women with UI do not seek help, the antenatal period may be a critical time for healthcare providers to identify those at risk, and encourage early prevention or effective management strategies. As physical activity is positively associated with better outcomes for obesity and psychological distress, there may also be concurrent improvements in UI if these issues are addressed., (© 2020 Wiley Periodicals LLC.)

Background and Objectives: General practitioners (GPs) often see children with enuresis and daytime urinary incontinence, and adults with persistent enuresis. The aim of this study was to assess Australian community health practitioners' knowledge and experiences with managing these conditions., Method: Health practitioners were surveyed about their knowledge and experience managing urinary incontinence that begins in childhood. Associations between participant characteristics and knowledge/experience were examined using chi-square tests., Results: The 1495 participants were mostly female, experienced, GPs who worked in a metropolitan area and/or saw patients with incontinence infrequently, but felt knowledgeable and confident about management of incontinence. Correct survey answers were given by 93% of participants for managing enuresis, 81% for daytime urinary incontinence (with 18% choosing inappropriate and potentially dangerous responses), and 61% for managing enuresis that has persisted into adulthood., Discussion: Better education is needed for GPs regarding management of urinary incontinence that begins in childhood, particularly for daytime incontinence in children and enuresis that persists into adulthood.

Aims: The experiences and information needs of clinicians who use pelvic floor muscle training to manage urinary incontinence were explored., Methods: Qualitative methods were used to conduct thematic analysis of data collected from clinician focus groups and interviews. Participants were registered physiotherapists and continence nurses in Melbourne, Australia. Recruitment was through a combination of purposive and "snowball" sampling and continued until data adequacy was reached., Results: Twenty-eight physiotherapists and one continence nurse participated in seven focus groups and one interview. The main finding communicated by the participants was that pelvic floor muscle training requires comprehensive descriptions of program details in order for clinicians to implement evidence-based interventions. The following themes were identified: (1) pelvic floor muscle training tailored to the needs of each individual is essential; (2) training-specific cues and verbal prompts assist patients to learn and engage with exercises; and (3) clinicians can benefit from research summaries and reports that provide explicit and comprehensive descriptions and decision rules about intervention content and progression. The data indicated that some clinicians can have difficulty interpreting and applying research findings because it is not always well reported., Conclusions: Clinicians who use pelvic floor muscle training to treat urinary incontinence advised can benefit from accessing explicit details of interventions tested in research and reported as effective. They viewed tailoring therapy to individual goals and the use of verbal prompts and visualization cues as important engagement strategies for effective exercise performance. Explicit reporting could be facilitated by using an exercise guideline template, such as the Consensus on Exercise Reporting Template (CERT)., (© 2018 Wiley Periodicals, Inc.)

Background: β-Adrenoceptor agonists are effective in animal models of bladder dysfunction, and the human bladder primarily expresses the β3 receptor subtype., Objective: To evaluate the efficacy and tolerability of the highly selective and potent β3-adrenoceptor agonist solabegron in a clinical proof-of-concept study in incontinent women with overactive bladder (OAB)., Design, Setting, and Participants: This was a randomized, double-blind trial in adult women with OAB (one or more 24-h incontinence episodes and eight or more average 24-h micturitions)., Interventions: Solabegron 50 mg (n=88), solabegron 125 mg (n=85), or placebo (n=85)-all twice daily-were administered., Outcome Measurements and Statistical Analysis: The primary efficacy end point was percentage change from baseline to week 8 in the number of incontinence episodes over 24 h. Secondary end points included actual change and percentage change from baseline to week 4 and week 8 in micturitions per 24 h, urgency episodes per 24 h, and volume voided per micturition. Adverse events (AEs) were assessed, as well., Results and Limitations: Solabegron 125 mg produced a statistically significant difference in percent change from baseline to week 8 in incontinence episodes over 24h when compared with placebo (p=0.025). Solabegron 125 mg treatment also showed statistically significant reductions from baseline to weeks 4 and 8 in micturitions over 24 h and a statistically significant increase from baseline to week 8 in urine volume voided. Solabegron was well tolerated, with a similar incidence of AEs in each treatment group. There were no significant treatment differences for mean changes from baseline to week 8 in systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), or heart rate during the 24-h ambulatory measurement., Conclusions: Solabegron significantly reduced the symptoms of OAB in women with moderate to severe OAB. Solabegron was safe, well tolerated, and did not demonstrate significant differences in AEs as compared to placebo. β3-Adrenoceptor agonists may represent a new therapeutic approach for treating OAB symptoms., (Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Objective: to describe the prevalence and impact on quality of life of urinary incontinence in a population-based cohort of older community-dwelling Australian men., Subjects: the population comprised 1,705 men aged >or=70 years participating in the Concord Health and Ageing in Men Project, a population-based study of urban older Australian men., Methods: data were collected between January 2005 and June 2007, and the participation rate was 47%. Data on demographics, medical history and from the 12-item Short Form Health Survey (SF-12) and International Consultation on Incontinence Questionnaire were collected. Urinary incontinence was defined as urinary leakage at least two times a week over the past 4 weeks., Results: the prevalence of urinary incontinence was 14.8%, increasing from 12.0% for men aged 70-74 years old to 16.3% for those aged >or=90 years, with urgency incontinence being the most frequent type of urinary incontinence. Daily urine leakage was reported by 3% of men. Men with incontinence had lower overall SF-12 scores with greater impact on the physical (PCS) than the mental (MCS) components of that scale. After adjusting for age, number of co-morbidities, enlarged prostate and prostate cancer, men with incontinence had worse PCS (43.6 vs 45.9) and MCS scores (52.2 vs 54.6) compared with continent men., Conclusion: urinary incontinence is common among older community-dwelling men and is associated with worse quality of life with greater impact on physical than mental factors. As the population ages, urinary incontinence prevalence will increase and increased resources will be needed to address this growing problem.

The aim of this study was to design and validate an interviewer-administered pelvic floor questionnaire that integrates bladder, bowel and sexual function, pelvic organ prolapse, severity, bothersomeness and condition-specific quality of life. Validation testing of the questionnaire was performed using data from 106 urogynaecological patients and a separately sampled community cohort of 49 women. Missing data did not exceed 2% for any question. It distinguished community and urogynaecological populations regarding pelvic floor dysfunction. The bladder domain correlated with the short version of the Urogenital Distress Inventory, bowel function with an established bowel questionnaire and prolapse symptoms with the International Continence Society prolapse quantification. Sexual function assessment reflected scores on the McCoy Female Sexuality Questionnaire. Cronbach's alpha coefficients were acceptable in all domains. Kappa coefficients of agreement for the test-retest analyses varied from 0.5 to 1.0. The interviewer-administered pelvic floor questionnaire assessed pelvic floor function in a reproducible and valid fashion in a typical urogynaecological clinic.

Background: International guidelines recommend treatment for urinary incontinence by a health professional such as a pelvic floor or continence physiotherapist with specialised training in the management of pelvic floor disorders., Objective: This article discusses the role of a physiotherapy program in treating women with urinary incontinence., Discussion: Treatment usually involves five consultations with a pelvic floor physiotherapist over 4-6 months. After an assessment of bladder function and the pelvic floor muscles, an individualised training program is prescribed. The focus of pelvic floor muscle training is to build strength, endurance, speed and the coordination of the pelvic floor muscles in different situations. An effective program has been shown to increase contractile strength as well as increased resting tone of the pelvic floor, which then provides improved support of the pelvic organs higher in the pelvis. Women may be offered an annual review by their physiotherapist in order to promote long term continence.

Background: Urinary incontinence is common in the community and may impact significantly on quality of life; yet only one-third of sufferers seek medical attention. There are many treatment options for patients suffering with urinary incontinence., Objective: This article aims to aid general practitioners in the management urinary incontinence. We outline the pathophysiology of urinary incontinence in women and provide a primary care treatment paradigm. Suggestions for when specialist referral would be of benefit are also discussed., Discussion: Most urinary incontinence can be evaluated and treated in the primary care setting after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle treatment. Urinary urgency responds to bladder training and pharmacotherapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence. If there is complex symptomatology or primary management fails, then referral to a specialist is suggested.

Leaking urine is frequently mentioned (anecdotally) by women as a barrier to physical activity. The aim of this paper was to use results from the Australian Longitudinal Study on Women's Health (ALSWH) to explore the prevalence of leaking urine in Australian women, and to ascertain whether leaking urine might be a barrier to participation for women. More than 41,000 women participated in the baseline surveys of the ALSWH in 1996. More than one third of the mid-age (45-50 years) and older (70-75) women and 13% of the young women (18-23) reported leaking urine. There was a cross-sectional association between leaking urine and physical activity, such that women with more frequent urinary leakage were also more likely to report low levels of physical activity. More than one thousand of those who reported leaking urine at baseline participated in a follow-up study in 1999. Of these, more than 40% of the mid-age women (who were aged 48-53 in 1999), and one in seven of the younger (21-26 years) and older (73-79 years) women reported leaking urine during sport or exercise. More than one third of the mid-age women and more than one quarter of the older women, but only 7% of the younger women said they avoided sporting activities because of leaking urine. The data are highly suggestive that leaking urine may be a barrier to physical activity, especially among mid-age women. As current estimates suggest that fewer than half of all Australian women are adequately active for health benefit, health professionals could be more proactive in raising this issue with women and offering help through non-invasive strategies such as pelvic floor muscle exercises.

The Women's Health Australia project provided the opportunity to examine the prevalence of leaking urine and associated variables in three large cohorts of Australian women 18-23 years of age ("young" N = 14,761), 45-50 ("mid-age" N = 14,070), and 70-75 ("older" N = 12, 893). The proportion of women reporting leaking urine was 12.8% (95% CI: 12.2-13.3), 36.1% (35.2- 37.0), and 35% (34.1- 35.9) in each of the three cohorts, respectively. Logistic regression analysis showed significant associations between leaking urine and parity in the young and mid-age women, and between leaking urine and constipation, other bowel symptoms, body mass index, and urine that burns or stings in all three groups. In the mid-age and older cohorts, women who reported having both hysterectomy and prolapse repair, or prolapse repair alone, were also more likely to report leaking urine. Lower scores on the physical and mental component summary scores of the medical outcomes survey short form (36 items) questionnaire suggest lower quality of life among women who report leaking urine, compared with those who do not. Neurourol. Urodynam. 18:567-577, 1999., (Copyright 1999 Wiley-Liss, Inc.)

A total of 1,012 patients referred to 4 urodynamic centres were questioned, and subsequently investigated. Coital incontinence was present in 192 of the 839 (23%), who were sexually active. Ninety-five patients (49%) had the urodynamic diagnosis of genuine stress incontinence, alone or in association with cystocoele or interstitial cystitis. Fifty-one (26.6%) had urodynamically proven detrusor instability with or without interstitial cystitis. Forty-five (23.4%) had dual pathology as the final urodynamic diagnosis.