Urinary Incontinence
- causes and risk factors
- signs, symptoms, and diagnosis
- pathophysiology
- treatments
- consequences and course
- the patient
- health care team
- community involvement
- resources and references
Stress incontinence is the involuntary loss of urine during increased intra-abdominal pressure (coughing, laughing, sneezing, exercising).
Functional incontinence
Urge incontinence is the involuntary loss of urine preceded by a strong urge to void, whether or not bladder is full
Mixed incontinence occurs with stress and urge incontinence.
Overflow incontinence
Causes and Risk Factors
Stress incontinence can be caused by
- displacment of the UVJ from its normal anatomic location; can occur following delivery, surgery
- intrinsic spincter deficiency (less common)
Urge:
- detrusor instability
- bladder irritants (infection, caffeine, cola, foreign bodies: sutures etc; poor PO intake)
Overflow inclontinece: obstruction of the urethra by various
- BPH
- prolapse
- surgery
Fistula: vesicovaginal or ureterovaginal fistulas (obstructed labour)
- infection
- diabetes
- constipation
- atrophic vaginitis
- neurological disease
- drugs
- mobility
- cognitive decline
Signs, Symptoms, and Diagnosis
- history
- physical exam
- lab investigations
- diagnostic imaging
History
Physical Exam
Lab Investigations
Diagnostic Imaging
Pathophysiology
Treatments
Conservative
- pelvic floor exercises
- pessaries
- medications: estrogens, alpha-adrenergics, duloxetine
Surgical
- burch colposuspension (open or laparoscopic)
- mid-urethral sling (TVT)
- sub-urethral slong
- trans-urethral injections
Urge incontinence
- caffeiene and nicotine out
- bladder drill
- anti-cholinergics
Consequences and Course
The Patient
Resources and References