urinary%20incontinence
URINARY INCONTINENCE
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.

Urinary%20incontinence Signs and Symptoms

Definition

Urinary Incontinence (UI)

  • Complaint of involuntary urine leakage

Stress Urinary Incontinence

  • Involuntary urine leakage on effort or exertion or when coughing or sneezing
  • Occurs during increased intraabdominal pressure that overcomes sphincter mechanism in the absence of bladder contraction
  • Irritative voiding symptoms & nocturia are absent
  • May be caused by poor pelvic support or intrinsic sphincter deficiency
  • Stress urinary incontinence in men is primarily associated w/ surgery of the prostate

Urge Urinary Incontinence

  • Involuntary urine leakage due to detrusor overactivity, associated w/ or immediately preceded by urgency
  • Patients are unable to hold back their urine when they feel the intense need to void
  • May be caused by detrusor myopathy, neuropathy, bladder CA, stones or infections

Mixed Urinary Incontinence

  • Involuntary urine leakage associated w/ both urgency & w/ exertion, effort, coughing or sneezing
  • Present when the bladder outlet is weak & detrusor is overactive

Overflow Incontinence

  • Also referred to as “incomplete emptying”, which describes the dribbling or continuous leakage associated w/ incomplete bladder emptying
  • May be caused by bladder overdistention, impaired detrusor contraction &/or bladder outlet obstruction
  • Associated symptoms include weak urinary stream, intermittency, hesitancy, frequency & nocturia

Incontinence related to reversible medical conditions

  • Transient incontinence
    • Arises from an acute medical condition affecting the lower urinary tract
    • Symptoms resolve when the medical condition is addressed & treated
  • Functional incontinence
    • Arises from chronic impairment of physical &/or cognitive functioning
    • Diagnosis of exclusion
    • Symptoms may resolve by improving patient’s functional status, treating comorbidities & changing medications

Overactive Bladder (OAB) Syndrome

  • Urgency w/ or w/o urge incontinence usually accompanied w/ complaints of frequency & nocturia

Risk Factors

Risk Factors for Urinary Incontinence (UI)

  • Irreversible factors
    • Increasing age, race, educational attainment, family history, childhood nocturnal enuresis or daytime wetting, multiparity, forceps delivery, menopause, hysterectomy, surgery for pelvic organ prolapse
  • Reversible factors
    • Body mass index >30, smoking, high caffeine intake, participation in high-impact sports, diabetes, depression, CNS disorders, recurrent UTI, constipation, drugs, pelvic organ prolapse, environmental barrier
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 5 days ago

Children who are fully vaccinated against the flu, ie, receive the recommended number of influenza vaccine doses, have a lower risk of acquiring influenza compared with those who are partially vaccinated, a US study found.

06 Jul 2020
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Pearl Toh, 29 Jun 2020
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Roshini Claire Anthony, 6 days ago

Upadacitinib may be a suitable treatment for patients with active psoriatic arthritis (PsA) who have insufficient response to non-biologic disease-modifying anti-rheumatic drugs (non-bDMARDs), according to results of the phase III SELECT-PsA-1* trial presented at EULAR 2020.