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Vol. 37. Issue 4.
Pages 199-213 (April 2013)
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Vol. 37. Issue 4.
Pages 199-213 (April 2013)
Special article
European Association of Urology guidelines on assessment and nonsurgical management of urinary incontinence
Guía clínica de la Asociación Europea de Urología sobre la evaluación y el tratamiento no quirúrgico de la incontinencia urinaria
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M.G. Lucasa,
Corresponding author
malcolm.lucas@wales.nhs.com

Corresponding author.
, R.J.L. Boschb, F.C. Burkhardc, F. Cruzd, T.B. Maddene, A.K. Nambiara, A. Neisiusf, D.J.M.K. de Ridderg, A. Tubaroh, W.H. Turneri, R.S. Pickardj
a Department of Urology, Morriston Hospital, Swansea, United Kingdom
b Department of Urology, UMC Utrecht, Utrecht, Holland, The Netherlands
c Department of Urology, University Hospital Bern, Berna, Switzerland
d Department of Urology, Hospital de São João and Faculty of Medicine of University of Porto, Oporto, Portugal
e The Royal Liverpool University Hospital, Liverpool, United Kingdom
f Department of Urology, Universitätsmedizin Mainz, Mainz, Germany
g Department of Urology, University Hospital Leuven, Lovaina, Belgium
h Department of Urology, Sant’ Andrea Hospital La Sapienza, Roma, Italy
i Department of Urology, Addenbrooke's Hospital, Cambridge, United Kingdom
j Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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Figures (2)
Tables (18)
Table 1. Recommendations for history taking and physical examination.
Table 2. Recommendations for voiding dairies.
Table 3. Recommendations for urinalysis and urinary tract infection.
Table 4. Recommendations for post-voiding residual volume.
Table 5. Recommendations for urodynamics.
Table 6. Recommendations for pad testing.
Table 7. Recommendation for imaging.
Table 8. Recommendations for simple clinical interventions.
Table 9. Recommendation for constipation.
Table 10. Evidence on containment.
Table 11. Recommendations for containment.
Table 12. Recommendations for lifestyle interventions.
Table 13. Evidence on Pelvic Floor Muscle Therapy (PFMT) as monotherapy.
Table 14. Recommendations for behavioural and physical therapies.
Table 15. Recommendations for antimuscarinic drugs.
Table 16. Recommendations for duloxetine.
Table 17. Recommendations for oestrogen.
Table 18. Recommendations for desmopressin.
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Abstract
Context

The previous European Association of Urology (EAU) guidelines on urinary incontinence comprised a summary of sections of the 2009 International Consultation on Incontinence. A decision was made in 2010 to rewrite these guidelines based on an independent systematic review carried out by the EAU guidelines panel, using a sustainable methodology.

Objective

We present a short version of the full guidelines on assessment, diagnosis, and nonsurgical treatment of urinary incontinence, with the aim of increasing their dissemination.

Evidence acquisition

Evidence appraisal included a pragmatic review of existing systematic reviews and independent new literature searches, based on Population, Intervention, Comparator, Outcome questions. Appraisal of papers was carried out by an international panel of experts, who also collaborated on a series of consensus discussions, to develop concise structured evidence summaries and action-based recommendations using a modified Oxford system.

Evidence summary

The full version of the guidelines is available online (http://www.uroweb.org/guidelines/online-guidelines/). The guidelines include algorithms that refer the reader back to the supporting evidence, and they are more immediately useable in daily clinical practice.

Conclusions

These new guidelines present an up-to-date summary of the available evidence, together with clear clinical algorithms and action-based recommendations based on the best available evidence. Where such evidence does not exist, they present a consensus of expert opinion.

Keywords:
Urinary incontinence
Practice-based guidelines
Diagnosis
Non-surgical treatment
European Association of Urology guidelines
Resumen
Contexto

La anterior guía clínica de la Asociación Europea de Urología (EAU) sobre incontinencia urinaria comprendía un resumen de las secciones de la Consulta Internacional de 2009 sobre la incontinencia. Se tomó la decisión en 2010 de volver a escribir esta guía clínica basándose en una revisión sistemática independiente llevada a cabo por el panel de guías clínicas de la EAU, utilizando una metodología sostenible.

Objetivo

Presentamos una versión resumida de la guía clínica completa sobre la evaluación, el diagnóstico y el tratamiento no quirúrgico de la incontinencia urinaria, con el objetivo de aumentar su difusión.

Adquisición de la evidencia

La valoración de la evidencia incluyó una revisión pragmática de las revisiones sistemáticas existentes y nuevas búsquedas bibliográficas independientes, basadas en cuestiones sobre población, intervención, comparador y resultados. La evaluación de los trabajos fue realizada por un panel internacional de expertos, quienes también colaboraron en una serie de debates de consenso, para desarrollar breves resúmenes de evidencia estructurada y recomendaciones basadas en la acción utilizando un sistema modificado de Oxford.

Resumen de la evidencia

La versión completa de la guía clínica está disponible online (http://www.uroweb.org/guidelines/online-guidelines/). La guía clínica incluye algoritmos que remiten de nuevo al lector a la evidencia de apoyo y son más inmediatamente utilizables en la práctica clínica diaria.

Conclusiones

Esta nueva guía clínica presenta un resumen actualizado de la evidencia disponible, junto con claros algoritmos clínicos y recomendaciones basadas en la acción fundamentadas en la mejor evidencia disponible. Cuando dicha evidencia no existe presentan un consenso de opiniones de expertos.

Palabras clave:
Incontinencia urinaria
Guías clínicas basadas en la práctica
Diagnóstico
Tratamiento no quirúrgico
Guía clínica de la Asociación Europea de Urología

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