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Conservative treatment options for women with stress urinary incontinence include lifestyle changes, pelvic floor muscle training, behavioural techniques, electrical stimulation and drugs, and combinations of these individual therapies. It would be very helpful to patients, primary care clinicians, and commissioners of services to know the relative worth of the wide variety of types and intensities of treatment currently offered to achieve greatest benefit from allocated resources. This article summarises the results of a recent Health Technology Assessment (HTA) commissioned by the UK Government’s National Institute for Health Research.1### LifestyleFor women who are overweight then participation in a supported weight-loss programme may improve incontinence. Other common-sense advice in terms of modification of fluid intake, smoking cessation, and resolving constipation may be worthwhile but lacks high-level evidence of benefit.### Pelvic floor muscle trainingPelvic floor muscle training (PFMT) aims to condition and strengthen the striated pelvic floor muscles through regular exercise in order to improve the urethral sphincter closure mechanism. The degree of patient training, supervision, intensity of exercise protocols, and follow-up varies, often related to local service provision and available expertise. In the UK the typical treatment protocol is two supervised sessions per month for 3 months.2### Vaginal conesWomen can be instructed to retain graded weights (cones) for timed periods within the vagina as a conditioning exercise to improve pelvic floor muscle strength. The ability to retain increasing weights for longer and with added provocation gives an element of biofeedback as well as exercise.### Behavioural therapyBladder training is often used to help women regain continence particularly for those with mixed symptoms of stress and urgency …

Conservative treatment options for women with stress urinary incontinence: clinical update