4 Extrapolation of the prevalence figures in the three overseas studies above 1-3 to the Australian population indicates that more than one million people in this country suffer from urine leakage. It would seem fortunate that this common and costly problem is eminently treatable in the community setting. However, many family doctors have scant knowledge about the different types of incontinence or their underlying causes, and do not understand how to assess or treat the problem. Incontinence is a Cinderella subject. Most doctors now in practice would have received little or no training about the issue in medical school, as much of our knowledge has developed in the last two decades.
Nobody dies from incontinence.
It is a pity that more general practitioners do not do more for their incontinent patients. Because many studies have shown that conservative regimens, which are readily administered by community caregivers, are highly efficacious. In both detrusor instability and stress incontinence, earlier treatment of less severe symptoms, avoiding the delay often incurred by specialist referral, is very advantageous. 9 Such treatment programs should be initiated, at the very first mention of the problem, by general practitioners, working together with community-based specialist nurse continence advisers. General practitioners are also ideally placed to implement strategies that promote continence.