Urinary%20incontinence Signs and Symptoms

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

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Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the condition whereby patients have metastatic prostate cancer and no prior hormonal therapy or androgen deprivation therapy (ADT). Typically, patients with mHSPC have been treated with ADT alone, following which, the overwhelming majority develop castration resistance over time and head towards eventual mortality. In recent years, the publication of various landmark trials has prompted dramatic changes in the mHSPC treatment landscape, and had favourably impacted overall survival (OS) in these patients. At a recent webinar, A/Prof Darren Poon, Honorary Consultant in Clinical Oncology, Hong Kong Sanatorium & Hospital, and Honorary Clinical Associate Professor, Department of Clinical Oncology, The Chinese University of Hong Kong, reviewed treatment options in mHSPC, while A/Prof Edmund Chiong, Head and Senior Consultant, Department of Urology, National University Hospital, Singapore, presented a case which was discussed by an esteemed panel of experts. This webinar was jointly organized by the Singapore Society of Oncology and the Singapore Urological Association, and supported by Astellas.