An Osteopathic Approach to Urinary Incontinence Including Biopsychosocial Aspects and Multiple Modalities for a Holistic Approach to Optimize Ongoing Care

Urinary incontinence is a nuanced and stigmatized condition that causes significant challenges for a large number of people in the United States and imposes a large financial and community burden. We provide an overview of major categorizations of incontinence by type as well as potential etiologies. We discuss how this condition impairs self-image, interferes with socialization, and can lead to depression and isolation; these elements inter-relate with access to care and implementation of the therapeutic options, further exacerbating patient suffering. We recognize the key components of patient evaluation regarding history and physical examination. Medicinal, surgical, and assistive device use are reviewed. Osteopathic manipulative treatments addressing the structures of the pelvis are also reviewed in detail. We illustrate how these techniques can be used to optimize outcomes. Utilizing a holistic approach to mitigate the multiple challenges that this condition presents can lead to greater success, reduced distress, and improved patient satisfaction.