Urinary%20incontinence%20in%20women Management

Management

Specialist Referral

Consider immediate referral to a specialist in the following conditions:
- Incontinence with abdominal and/or pelvic pain
- Hematuria in the absence of an infection
- Suspected fistula
- Complex neurological conditions (eg Parkinson’s disease, spinal cord injury)
- Abnormal findings (eg pelvic mass or symptomatic organ prolapse beyond the hymen, palpable bladder after voiding on abdominal or bimanual exam)
Consider elective referral to a specialist in the following conditions:
- Persistent symptoms after an adequate therapeutic trial
- Uncertain diagnosis and lack of reasonable treatment plan
- Significant increase in PVRV that does not resolve after treatment of possible precipitants (eg medications, stool impaction)
- Prior pelvic surgery or pelvic irradiation
- Desire for surgical treatment
  - Concurrent surgery for stress UI and pelvic organ prolapse may be considered in women with both stress UI and anterior and/or apical prolapse

Updates in the Management of Osteoporotic Fracture Risk

Dr. Chionh Siok Bee, Dr. Charles A Inderjeeth, 29 Nov 2018

Osteoporosis is a bone condition characterized by reduced bone mass and microarchitectural deterioration of bone tissue, consequently increasing bone fragility and fracture susceptibility.¹ Despite being a major cause of death and disability, osteoporosis is significantly underdiagnosed and undertreated in Asia.² At a recent symposium supported by the Osteoporosis Society (Singapore) and organized by Amgen, local expert Dr Chionh Siok Bee presented an overview of the fracture landscape in Singapore, while internationally renowned guest speaker Dr Charles A Inderjeeth discussed the importance of identifying and managing osteoporosis fracture risk, with a focus on the role of antiresorptive agent denosumab.

MONALEESA-2: Compelling survival data with ribociclib a ‘step forward’ in HR+/HER2- ABC

15 Nov 2021

Adding ribociclib (KISQALI, Novartis) to letrozole yields significant and consistent overall survival (OS) benefit compared with letrozole alone in the first-line setting for postmenopausal women with hormone receptor-positive (HR+), HER2-negative (HER2-) advanced breast cancer (ABC), according to the final OS analysis of the MONALEESA-2 trial presented at ESMO 2021.

The safe and rational use of ulipristal for fibroids

Dr. Siow Yew Ming Anthony, 20 Jun 2019

Fibroids or leiomyomas are the most common benign smooth muscle tumours of the uterus. They are often detected at screening ultrasound in asymptomatic patients. A fibroid will naturally grow until menopause and subsequently shrink when female hormone levels drop.