This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
AHCPR releases update to urinary incontinence guideline
The Agency for Health Care Policy and Research recently released
an updated version of its clinical practice guideline on urinary
incontinence (UI) first issued in March of 1992. The updated
guideline has expanded sections on diagnosis and behavioral
therapies, as well as a new chapter on treating chronic UI in
long-term and home care settings.
Urinary incontinence is one of the primary contributing reasons
that people enter nursing facilities, yet 80 percent of cases can
be improved or cured by following the guideline's
recommendations. Use of the guideline may help people stay at
home longer and improve the quality of life for persons at home
or in facilities.
Researchers estimate the Nation spends at least $16 billion a
year to care for people with UI, up from $10 billion in 1990.
Urinary incontinence is estimated to affect more than 13 million
adults—most of them older women—but actual prevalence
may be higher because it is widely underreported and
As with the first version, this updated guideline was developed
by a private sector, multidisciplinary panel of clinicians and a
consumer. The panel was co-chaired by Andrew J. Fantl, M.D.,
Professor and Vice-Chair of the Obstetrics, Gynecology, and
Reproductive Medicine Department at SUNY at Stonybrook School of
Medicine, and Diane Kaschak Newman, R.N.C., M.S.N., F.A.A.N.,
President of Access to Continence Care and Treatment,
Incontinence can be caused by pelvic muscle instability, as a
side effect of medications or caffeine, or other conditions such
as a urinary tract infection or constipation. It also can be
caused by not being able to reach the bathroom in time due to a
lack of mobility. Many younger women experience incontinence
after childbirth but don't report it because they are
embarrassed or feel it is an inevitable result of the birthing
process. Older men with prostate problems or recovering from
prostate surgery often suffer from incontinence but are more
likely to ask for and receive help for the condition.
According to the guideline panel co-chairs, surveys have shown
that women tend to accept incontinence as their personal burden,
while men understand that UI is not normal and should be treated.
They point out that clinicians need to ask women about
incontinence and treat it aggressively.
The guideline is written for the primary care provider and covers
various types of incontinence, provides a framework for selecting
appropriate behavioral, pharmacologic, and surgical treatments,
and evaluates the use of alternative treatments such as catheters
and bladder support devices.
AHCPR is working collaboratively with the American Medical
Directors Association (AMDA) and the American Health Care
Association (AHCA) to develop new materials to increase
caregivers' understanding of UI. The caregiver guide will be
written specifically for certified nursing assistants in nursing
facilities and home health aides. A companion piece will be
written for directors of nursing to help them train caregivers.
The new materials will be available later this summer.
The American Medical Directors Association is a national
professional organization representing physicians who practice in
long-term care facilities as medical directors or attending
physicians. The American Health Care Association is a federation
of 51 State associations representing more than 11,000 long-term
care facilities nationwide, caring for more than 1 million
elderly, chronically ill, and convalescent Americans.
A quick reference guide for clinicians, Managing Acute and
Chronic Urinary Incontinence (AHCPR Publication No. 96-0686),
and a consumer guide, Understanding Incontinence, in
English (AHCPR Publication No. 96-0684) or Spanish (AHCPR
Publication No. 96-0685), are available from AHCPR.
Single and bulk copies of the complete clinical practice
guideline, Urinary Incontinence in Adults: Acute and Chronic
Management, are available from the Superintendent of
Documents, U.S. Government Printing Office (stock number
017-026-00155-7; $6 per copy). Bulk copies of the quick reference
guide (stock number 017-026-00156-5, $27 per pack of 20) and the
consumer guide (English only; stock number 017-026-00157-3, $10
per pack of 20) also are available from GPO. To order, call the
GPO order desk at (202) 512-1800 (credit card and deposit account
orders only) or write to Superintendent of Documents, P.O. Box
371954, Pittsburgh, PA 15205-7954.
Select for the UI guideline, quick reference guide, and English and Spanish consumer guides.
Editor's Note: As explained in Administrator
testifies in support of AHCPR's FY 97 budget, AHCPR has implemented a new policy on
clinical practice guidelines. AHCPR will no longer be directly involved in guideline development
but will work as a "science partner" with private-sector groups to supply the scientific evidence
they need to develop their own clinical practice guidelines.]
Return to Contents
Proceed to Next Section