Conservative treatment of urinary stress incontinence.

Almost half of all women who exercise regularly experience some degree of urinary stress incontinence. The cause is often multifactorial, but physical activity often aggravates it. Because denial is commonplace, at each yearly gynecologic exam primary care physicians should ask patients about urologic problems. If a problem exists, a urinary questionnaire and voiding diary can help determine the nature of the condition. In addition, a thorough medical, urologic, and gynecologic history can help pinpoint the cause. Physical exam can reveal such conditions as neurologic deficits and pelvic floor weakness, and other tests can rule out infection and other disorders. Conservative treatment, which may involve drugs, pelvic floor strengthening, and mechanical devices, often restores continence.