Urinary incontinence in women: treatment recommendations

The use of mesh in treating urinary incontinence and pelvic organ prolapse—conditions that are common after childbirth—has come under intense scrutiny with much public concern. Many women may have the mesh implanted without a problem; however, for others, it can lead to unacceptable complications that include the mesh cutting into organs or through tissues, intense pain and recurring infection.

Recommendations produced by the National Institute for Health and Care Excellence (NICE) (2019) suggest that the full range of non-surgical options should be offered to those women with urinary incontinence and pelvic floor prolapse prior to any surgical procedures being undertaken. The non-surgical options include lifestyle interventions, physical therapies, behavioural therapies and medications that are used for urinary incontinence. Non-surgical options for pelvic organ prolapse include lifestyle modification, the use of topical oestrogen, pelvic floor muscle training and pessary management.

The 2019 NICE recommendation take into account the previous 2016 and 2013 recommendations and guidance. These 2019 recommendations replace the 2013 clinical guideline (NICE, 2013) and the 2016 interventional procedures guidance (NICE 2016). They are based on the NICE (2015) Quality Standard, Urinary Incontinence in Women.