title: The role of general practitioners in the initial management of women with urinary incontinence in France, Germany, Spain and the UK.
abstract: OBJECTIVE
  To describe the role of general practitioners (GPs) in the initial management of women with urinary incontinence (UI) in four European countries with different healthcare systems.
  
  
  METHODS
  Cross-sectional community postal survey of 2953 women with UI in France, Germany, Spain and the UK.
  
  
  RESULTS
  Forty-eight per cent of community-dwelling women with UI had discussed their UI with a doctor. More women discussed UI in France and Germany than in the UK and Spain. The patient usually raised the issue during consultations for some other reason. Fear of or actual deterioration in UI was the most important reason for discussing UI. Overall, 52% of incontinent women first discussed their UI with a GP, and almost a third of women reported having all their UI discussions in a GP setting. Twenty-nine per cent of women reported that GPs had either recommended treatment or monitoring of their condition before beginning treatment, and 24% reported that the GP had referred them to another doctor for evaluation and treatment. Most women in the UK first discussed UI with a GP, whereas in Germany most discussed UI with a specialist. In Spain and France, about half the women first discussed their UI with a GP.
  
  
  CONCLUSIONS
  GPs are involved to varying degrees in the initial management of UI in France, Germany, Spain and the UK. Even in countries where women have a choice of whether to see a GP or specialist about UI, many choose to have their first contact with a GP.
authors: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. maire.odonnell@isf.uib.no
authors: Máire
authors: M
authors: O'Donnell
authors: Lars
authors: L
authors: Viktrup
authors: Steinar
authors: S
authors: Hunskaar
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D005602:France; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010819:Physician's Role; D013030:Spain; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014549:Urinary Incontinence / Q000628:therapy*