How to Treat Genital Prolapse And Urinary Incontinence?

Things to note:
  • Detrusor overactivity: bladder training, fluid restriction and physiotherapy.
  • Stress incontinence: pelvic floor exercises.
  • Surgical procedures as dictated by the diagnosis at specialist care.

Medical Treatment:
  • Treat urinary tract infections and underlying conditions, as appropriate.
For detrusor overactivity as demonstrated on urodynamic studies:
  • Oxybutynin, oral, 2.5 mg 12 hourly, increasing to 5 mg 6 hourly. Specialist initiated.
  • Dry mouth is a common side effect of treatment.

When to refer:
  • All patients with prolapse.
  • Patients not responding to therapy.
  • Incontinence:
    • Stress incontinence as surgical repair will be likely.
    • Total incontinence as a fistula has to be excluded.
    • Urge incontinence resistant to 3 months Medicine.
    • Mixed incontinence (both stress and urge incontinence present) as surgery will play a role.