**2. Initial assessment**

In the UK, 3.5 millions women suffer from urogynaecological problem however not every patient has symptoms that impact their quality of life and led them to seek medical attention. One in every ten women over the age of 35 suffers a degree of urinary incontinence [1, 2]. Specialised urogyanecology nurse are able to stratify the patient symptoms according to lower urinary tract symptoms groups which mainly are;

*Stress urinary incontinence defined as involuntary leakage of urine with effort or exertion, or on sneezing or coughing [3].*

*Urge urinary incontinence defined as involuntary leakage of urine accompanied by a strong desire to pass urine (void) [3].*

*Mixed urinary incontinence defined as involuntary leakage of urine associated both with urgency and with exertion, effort, sneezing or coughing. Commonly, one of the two elements are predominant and most bothersome [3].*

*Daytime frequency is defined when a woman perceives that she voids too often during the day [3].*

*Nocturia is defined wake at night more than one time at night to void up to the age of 70 years [3].*

*Nocturnal enuresis defined as incontinence occurring during sleep [3].*

*Urgency defined as sudden compelling desire to pass urine, which is difficult to defer [3].*

*Over active bladder syndrome defined as occurrence of combination of urgency, frequency, urge incontinence and potentially nocturne and nocturnal enuresis.*

*Overflow incontinence defined as involuntary loss of urine without warning or precipitating factor and it occurs when the bladder becomes large and flaccid and has little or no detrusor tone or function [3].*

*Incontinence due to a fistula which can be vesicovaginal, ureterovaginal or urethrovaginal fistula [3].*

*Voiding difficulties includes hesitancy; that is, difficulty in initiating micturition, straining to void and slow or intermittent urinary stream, or post micturition ripples and feeling of incomplete emptying. They are indicative for urethral obstruction muscle, or loss of coordination between detrusor contractions and urethral relaxation [3].*

*Absent or reduced bladder sensation is usually due to denervation caused by spinal cord injuries or pelvic surgery. It leads to infrequent micturition and a large-capacity bladder, and is often associated with overflow incontinence [3].*

*Haematuria defined as presence of blood in the urine. This can be microscopic or macroscopic (frank). It is always warrants further investigation [3]*

*Bladder pain is common with urinary tract infections but also can indicate chronic inflammatory changes that is present in interstitial cystitis where the bladder pain is usually better with emptying [4]*

The initial assessment should also gathering the relevant information about; Weight and body mass index (BMI), blood pressure, Signs of systemic disease especially neurological problems and Mobility and mental state [5].

*Role of Nursing in Urogynaecology DOI: http://dx.doi.org/10.5772/intechopen.107275*

Urinary incontinence and other lower urinary tract has significant impact on women's life starting from a lower emotional wellbeing up to social isolation and planning daily activities around places with toilet availability. There are questioners that assess the impact of lower urinary tract symptoms on quality of life which is a vital aspect in the initial assessment. A well trained nursing staff should be able to analyse such questionnaire [4–9].
