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
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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