Medical management of urinary incontinence in women

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FIGURE 1
Muscles of the pelvic floor. The iliococcygeus, puborectalis, and pubococcygeus muscles make up the levator ani.
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FIGURE 2
A ring pessary in place.

TABLE 1

American College of Physicians recommendations on urinary incontinence in women

Stress incontinence	Urgency incontinence	Mixed incontinence	For all
Pelvic floor muscle training Strong recommendation, high-quality evidence Against drug treatment Strong recommendation, low-quality evidence	Bladder training Weak recommendation, low-quality evidence Drug treatment if bladder training was unsuccessful Strong recommendation, high-quality evidence	Pelvic floor muscle training with bladder training Strong recommendation, high-quality evidence	Weight loss and exercise if obese Strong recommendation, moderate-quality evidence