Urinary incontinence

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Obesity, Sleep & Internal medicine
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Urinary incontinence
Synonyms	Involuntary urination
Pronounce	N/A
Specialty	N/A
Symptoms	Urine leakage
Complications	Skin infection, urinary tract infection, emotional distress
Onset	Can occur at any age, more common in older adults
Duration	Can be temporary or chronic
Types	Stress incontinence, urge incontinence, overflow incontinence, functional incontinence, mixed incontinence
Causes	Pregnancy, childbirth, menopause, prostate surgery, neurological disorders, obesity, medications
Risks	Age, gender, obesity, smoking, family history
Diagnosis	Medical history, physical examination, urinalysis, bladder diary, urodynamic testing
Differential diagnosis	Overactive bladder, urinary tract infection, interstitial cystitis
Prevention	Pelvic floor exercises, weight management, bladder training
Treatment	Lifestyle changes, pelvic floor exercises, medications, surgery, catheterization
Medication	Anticholinergics, beta-3 adrenergic agonists, topical estrogen
Prognosis	N/A
Frequency	Affects millions worldwide, more common in women
Deaths	Rarely directly fatal, but can lead to complications

Urinary incontinence is a common medical condition that involves a loss of bladder control, resulting in involuntary leakage of urine. It's an often embarrassing problem and prevalence increases with age, especially affecting women more than men.

Burch suspension for urinary incontinence, N00637-H

Introduction

Urinary incontinence is not a disease in itself but is a symptom of underlying medical conditions, lifestyle habits, or physical problems. It can range from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time.

Types of Urinary Incontinence

• Urinary incontinence is typically divided into several types:
• Stress Incontinence: Leakage of urine during physical activities that increase abdominal pressure such as coughing, sneezing, laughing, or lifting heavy objects.
• Urge Incontinence: Also known as overactive bladder, characterized by a sudden, intense urge to urinate followed by an involuntary loss of urine.
• Overflow Incontinence: Characterized by the inability to empty the bladder completely, leading to frequent or constant dribbling of urine.
• Functional Incontinence: Occurs when physical or mental impairments prevent a person from reaching the toilet in time.
• Mixed Incontinence: When a person experiences more than one type of urinary incontinence.

Causes and Risk Factors

Causes of urinary incontinence can be temporary or persistent. Temporary causes include certain drinks, foods and medications that act as diuretics. Persistent urinary incontinence may be due to underlying physical problems or changes such as aging, hysterectomy, enlarged prostate, or neurological disorders.

Diagnosis

The process of diagnosing urinary incontinence typically involves a thorough medical history, physical examination, bladder diary, and tests such as urinalysis, bladder scan, and urodynamic testing. In some cases, more specialized tests like cystoscopy or imaging tests may be performed.

Treatment

Treatment for urinary incontinence is tailored to the type of incontinence, the severity of symptoms, and the underlying cause. It can range from lifestyle changes, bladder training, pelvic floor muscle exercises, medications, medical devices, interventional therapies to surgery.

Prognosis

The outlook for urinary incontinence depends on its cause. With appropriate management and treatment, most people with this condition can achieve significant relief or even a complete resolution of symptoms.

References

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• Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-178.
• Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589-593.
• Leron E, Weintraub AY, Mastrolia SA, Schwarzman P. Overactive bladder syndrome: Evaluation and management. Curr Urol. 2018;11(3):117-125.

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