Urinary incontinence differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Syed Hassan A. Kazmi BSc, MD [3]
Overview
Urinary incontinence may have different etiologies depending upon the underlying dysfunction. The various types of urinary incontinence should be differentiated from each other for optimal management.
Differential diagnosis of urinary incontinence
The following table differentiates the various types of urinary incontinence:[1][2][3][4][5][6][7][8]
To review differential diagnosis of urge incontinence, click here.
To review differential diagnosis of stress incontinence, click here.
To review differential diagnosis of functional incontinence, click here.
To review differential diagnosis of overflow incontinence, click here.
To review differential diagnosis of mixed incontinence, click here.
| Category | Diseases | Type of incontinence | Clinical manifestations | Para−clinical findings | Gold standard | Additional findings | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | ||||||||||||||||||||||
| Lab Findings | Imaging | ||||||||||||||||||||||
| Loss of consciousness | Fever | Pelvic pain | Urinary symptoms | BP | Edema | Neurological deficit | Urine residue | UA | Other | Ultrasound | CT scan | Other | |||||||||||
| Urge | Stress | Functional | Overflow | Dysuria | Frequency | Dribbling | Nocturia | ||||||||||||||||
| Neurological diseases | Stroke[9] | + | + | ± | − | + | − | − | ± | + | + | ++ | ↑/↓ | − | + | < 50 ml | Pyuria | NA | Imaging |
| |||
| Alzheimer's disease[10] | + | + | + | + | − | − | ± | ± | + | + | ++ | Nl | − | + | < 50 ml | Pyuria | NA |
| |||||
| Parkinson's disease[11] | + | − | − | − | − | − | − | ± | + | + | ++ | Nl | − | + | < 50 ml | Nl | NA | ||||||
| Altered mental status | − | − | + | − | − | + | + | < 50 ml | |||||||||||||||
| Traumatic spinal cord injury | − | + | − | − | − | + | ± | < 50 ml | |||||||||||||||
| Multiple sclerosis | + | − | − | + | + | − | + | > 200 ml | |||||||||||||||
| Category | Diseases | Urge | Stress | Functional | Overflow | Loss of consciousness | Fever | Abdominal pain | Dysuria | Frequency | Dribbling | Nocturia | BP | Edema | Neurological deficit | Urine residue | UA | Other | Ultrasound | CT scan | Other | Gold standard | Additional findings |
| Urogenital disorders | Benign prostatic hyperplasia | + | − | − | + | + | + | + | > 200 ml | ||||||||||||||
| Genitourinary surgical procedures | + | + | − | − | + | + | + | < 50 ml | |||||||||||||||
| Multiple childbirths | + | + | − | − | + | + | + | < 50 ml | |||||||||||||||
| Uterine fibroids | − | − | − | + | − | + | + | > 200 ml | |||||||||||||||
| Uterine prolapse | − | + | − | − | − | + | ± | < 50 ml | |||||||||||||||
| Gastrointestinal diseases | Fecal impaction | − | − | − | + | − | + | + | > 200 ml | ||||||||||||||
| Rectal prolapse | − | − | − | + | − | + | + | > 200 ml | |||||||||||||||
| Category | Diseases | Urge | Stress | Functional | Overflow | Loss of consciousness | Fever | Abdominal pain | Dysuria | Frequency | Dribbling | Nocturia | BP | Edema | Neurological deficit | Urine residue | UA | Other | Ultrasound | CT scan | Other | Gold standard | Additional findings |
References
- ↑ "pdfs.semanticscholar.org" (PDF).
- ↑ Brown JS, Bradley CS, Subak LL, Richter HE, Kraus SR, Brubaker L, Lin F, Vittinghoff E, Grady D (May 2006). "The sensitivity and specificity of a simple test to distinguish between urge and stress urinary incontinence". Ann. Intern. Med. 144 (10): 715–23. PMC 1557357. PMID 16702587.
- ↑ Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE (March 2008). "What type of urinary incontinence does this woman have?". JAMA. 299 (12): 1446–56. doi:10.1001/jama.299.12.1446. PMID 18364487.
- ↑ Videla FL, Wall LL (June 1998). "Stress incontinence diagnosed without multichannel urodynamic studies". Obstet Gynecol. 91 (6): 965–8. PMID 9611005.
- ↑ DuBeau CE, Kuchel GA, Johnson T, Palmer MH, Wagg A (2010). "Incontinence in the frail elderly: report from the 4th International Consultation on Incontinence". Neurourol. Urodyn. 29 (1): 165–78. doi:10.1002/nau.20842. PMID 20025027.
- ↑ "Diagnosis of Urinary Incontinence - American Family Physician".
- ↑ Frank C, Szlanta A (November 2010). "Office management of urinary incontinence among older patients". Can Fam Physician. 56 (11): 1115–20. PMC 2980426. PMID 21075990.
- ↑ Imam KA (2004). "The role of the primary care physician in the management of bladder dysfunction". Rev Urol. 6 Suppl 1: S38–44. PMC 1472846. PMID 16985854.
- ↑ Gibson J, Thomas LH, Harrison JJ, Watkins CL (March 2018). "Stroke survivors' and carers' experiences of a systematic voiding programme to treat urinary incontinence after stroke". J Clin Nurs. doi:10.1111/jocn.14346. PMID 29517816. Vancouver style error: initials (help)
- ↑ Lee, Hsiang-Ying; Li, Ching-Chia; Juan, Yung-Shun; Chang, Yu-Han; Yeh, Hsin-Chih; Tsai, Chia-Chun; Chueh, Kuang-Shun; Wu, Wen-Jeng; Yang, Yuan-Han (2016). "Urinary Incontinence in Alzheimer's Disease". American Journal of Alzheimer's Disease & Other Dementiasr. 32 (1): 51–55. doi:10.1177/1533317516680900. ISSN 1533-3175.
- ↑ Siegl E, Lassen B, Saxer S (September 2013). "[Incontinence--a common issue for people with Parkinson's disease. A systematic literature review]". Pflege Z (in German). 66 (9): 540–4. PMID 24137917.