March 2026
Automated screening may increase urinary incontinence diagnoses in primary care
By Rebecca Jenkins
An automated urinary incontinence (UI) screening program is associated with an increase in the number of women being diagnosed with the condition, suggests a primary care study published in JAMA Internal Medicine.
UI is a common condition in women. But despite being treatable, it is under-reported with patients often embarrassed to seek help, the US study authors wrote.
They designed a project incorporating automated screening for UI as part of the intake process for routine annual primary care visits, with women reporting symptoms offered the opportunity to use an educational computer-based tool about UI and treatment options.
Women were invited for automated online screening three days before a routine primary care visit to 43 primary care clinics, with the screening asking whether they had ‘bothersome leakage of urine’.
Of the patients screened, 72,000 (71%) responded to the screening question, with the UI prevalence reaching 11,383 women (16.5% of respondents).
The authors reported a 1.4-fold increase in absolute rate in UI diagnosis during the screening, compared with before the intervention, and a 1.9-fold increase in annual change.
Rates of referral to pelvic floor therapy and subspecialty care also increased, but there was no change in the number of prescriptions for UI medications.
‘Findings of this study suggest that large-scale implementation of an automatic UI screening and education program in primary care practices is a feasible option for increasing awareness and promoting treatment of UI in women,’ the authors concluded.
Professor Andrew Korda, Consultant Emeritus in Gynaecology and Urogynaecology at the Royal Prince Alfred Hospital, Sydney, said the research was of good quality and showed it was possible to identify patients in need by simply asking questions about incontinence.
An intervention like the one trialled in the study could feasibly be introduced to Australia, he noted, but it would require a major co-ordinated effort, funding and an interested researcher to trial it.
Currently, there were no published statistics on how often GPs asked about UI, Professor Korda said; however, a UK study had shown only 20 to 40% of GPs routinely asked about the condition.
‘There is evidence from Continence Health Australia that many people don’t talk to their GPs about the issue as they are embarrassed about the problem,’ Professor Korda said.
‘We know that four in 10 people experience incontinence with women more likely to be affected: it is important to ask women about this issue as part of the routine system review, when consulting.’