Urinary incontinence: when to refer for procedural therapies.

Urinary incontinence is not life-threatening but rather is a social problem for older women. Therefore, 'patient selection' for a surgical intervention is up to the patient. The physician's role is to educate patients about available procedures, including potential complications and success rates. Invasive treatments for stress incontinence include retropubic or needle suspension, sling procedures, injections of periurethral bulking agents such as collagen, and implantation of an artificial sphincter. An electrical nerve stimulation device has recently been approved for urge incontinence. Many consumer advocacy groups provide support and patient education on incontinence.