Management of urinary incontinence in general practice: data from the Second Dutch National Survey

Objective  The aim of this study was to provide insight into the referral pattern of newly diagnosed patients with urinary incontinence in general practice and into the prescription of medication and incontinence pads by general practitioners (GPs). We also examined the influence of gender and age of patient/GP on these patterns.
Methods  Data were obtained from the Second Dutch National Survey of General Practice. We used registered new episodes for urinary incontinence of patients of 25 years and older in the year 2001 and examined the initial management.
Results  Twelve per cent of the patients were referred to a physiotherapist, 2.4% to a gynaecologist and 2.9% to a urologist. Medication was prescribed to 9.8% and 12.7% received incontinence pads. The number of female patients referred decreased significantly after 60 years of age and the number of incontinence pads and medication prescribed was higher in this age patient group. Gender of the GP did not influence the prescription or referral rate. Male patients were significantly less frequently referred than female patients.
Conclusion  The lower referral rate and higher prescription rate of incontinence pads and medication at older age indicate that GPs are not sufficiently aware of the benefits of pelvic floor muscle training and bladder training at older age.
We did not find an influence of gender of the GP on management of urinary incontinence, unlike previous research. GPs were reluctant in prescribing medication, which is in agreement with national and international guidelines.