This guideline covers the care and treatment of women aged 18 years and older with urinary incontinence (stress, urgency or mixed urinary incontinence, or overactive bladder). It aims to improve the physical, psychological and social wellbeing of women who have urinary incontinence.
July 2018: The Government has announced a pause on the use of vaginally inserted mesh and tape to treat stress urinary incontinence and pelvic organ prolapse in England. This follows a recommendation by Baroness Cumberlege, who is chairing an independent review of surgical mesh procedures and has heard from women and families affected by them. For details, see the letter from NHS England and NHS Improvement to trust medical directors. We will work with NHS England to produce a shared decision making tool, to be available when our updated guideline on guideline on urinary incontinence and pelvic organ prolapse publishes early next year.
This guideline includes recommendations on:
- assessment and investigation
- lifestyle, physical and behavioural interventions
- alternative conservative management options
- pharmacological treatment
- invasive procedures for overactive bladder
- surgical approaches for stress urinary incontinence
Who is it for?
- Healthcare professionals
- Women 18 years and older with urinary incontinence, and their families and carers
Is this guideline up to date?
We reviewed the evidence in March 2016 and we are updating the recommendations on surgical approaches for stress urinary incontinence and extending the scope to include pelvic organ prolapse. See the guideline in development page for progress on the update.
Guideline development process
This guidance updates and replaces NICE guideline CG40 (October 2006), NICE technology appraisal guidance 56 (February 2003) and NICE advice ESNM2 (September 2012).
This guideline was previously called urinary incontinence: the management of urinary incontinence in women.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.