Critical review of guidelines for female urinary incontinence diagnosis and treatment

Objectives. - To provide a critical review of the currently available guidelines on female urinary incontinence diagnosis and treatment. Methods. - Through a review of Medline, we identified the guidelines produced by five associations: French Urological Association (AFU), French National College of Gynaecologists and Obstetricians (CNGOF), American Urological Association (AUA), European Association of Urology (EAU) and International Urogynecological Association (IUGA). These guidelines were evaluated by the instrument provided by the Appraisal of Guidelines, Research and Evaluation. Then, the diagnosis and treatment recommendations were compared. Results. - The quality of guidelines were variable. Three of them (CNGOF, AFU, EAU) yielded to a score of more than 70. The rigor of development was not always optimal with a dilemma between evidence based medicine and the practice of experts. The best guidelines based on excellent meta-analysis failed to consider the recent modifications of management. Conclusions. - We found many differences in the quality of available guidelines. (C) 2012 Elsevier Masson SAS. All rights reserved.