Mrs Banks is 52 years old and presents to the GP as her incontinence is no better following pelvic floor muscle training. She was referred for physiotherapy earlier in the year and has now trialled this for 4 months. Her main concern is leaks of urine when coughing and exercising. Lifestyle measures including limiting caffeine intake had little impact on symptoms. She has no surgical history and her son was born with a normal vaginal delivery.
There is no haematuria, dysuria or urgency, and previous abdominal and pelvic examinations were normal. Urine dipstick is also normal. She is not keen on surgical options at this stage but feels very upset about her symptoms.
What would be the next most appropriate management plan for her?