2024 Revised Dutch guidelines for urinary incontinence: Addressing clinical bottlenecks through a modular approach

The Dutch Urological Association (NVU) has revised its guidelines for the treatment of urinary incontinence (UI) in secondary and tertiary care, updating the 2014 guidelines to address specific clinical bottlenecks within the Dutch healthcare system. While grounded in the European guidelines, the Dutch version employs a modular approach to ensure relevance and practicality. Key updates cover surgery for women with stress urinary incontinence (SUI) and prolapse, use of bulking agents, male slings for post-prostatectomy incontinence (PPI), intravesical botulinum toxin injections or neuromodulation techniques for refractory urge urinary incontinence (UUI), beta-3 receptor agonists, and pharmacological treatments for the elderly. The guidelines emphasize shared decision-making (SDM), appropriate care settings, and the integration of Patient-Reported Outcome Measures (PROMs) to enhance treatment evaluation and patient outcomes. This multidisciplinary and evidence- based approach aims to improve the quality and effectiveness of urinary incontinence management in the Netherlands