Urinary incontinence is the complaint of involuntary urine leakage.
Stress urinary incontinence is the involuntary urine leakage on effort or exertion or when coughing or sneezing.
Urge urinary incontinence is the one associated with or immediately preceded by urgency.
Mixed urinary incontinence is the involuntary urine leakage associated with both urgency and with exertion, effort, coughing or sneezing.


Consider immediate referral to a specialist in the following conditions:

  • Incontinence w/ abdominal &/or pelvic pain
  • Hematuria in the absence of an infection
  • Suspected fistula
  • Complex neurological conditions (eg Parkinson’s disease, spinal cord injury)
  • Abnormal findings (eg pelvic mass or symptomatic organ prolapse beyond the hymen)

Consider elective referral to a specialist in the following conditions:

  • Persistent symptoms after an adequate therapeutic trial
  • Uncertain diagnosis & lack of reasonable treatment plan
  • Significant increase in PVRV that does not resolve after treatment of possible precipitants (eg medications, stool impaction)
  • Prior pelvic surgery or pelvic irradiation
  • Desire for surgical treatment
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