Urinary incontinence resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Overview
This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.
Causes
Life Threatening Causes
- Idiopathic parkinson's disease
- Infection
- Limbic encephalitis
- Metastatic prostate cancer
- Mitochondrial parkinson's disease
- Multiple sclerosis
- Parkinson disease
- Pelvic cancer
- Prostate cancer
- Schaefer-stein-oshman syndrome
- Spinal cord neoplasm
- Spinal fracture
- Stroke
- Toxic mushrooms
- Tumor
- Wilms tumor
- Wohlwill-andrade syndrome
Common Causes
- Bladder Cancer[3][4][5][6][7][8][9][10]
- Botulinum toxin
- Delerium
- Drugs: Bethanechol chloride, Meropenem, Tiagabine
- Infection
- Inflammation
- Multiparity
- Neuropathic bladder dysfunction
- Neurologic
- Obesity
- Obstetric/gynecologic surgery
- Outlet obstruction
- Pelvic surgery
- Polyuria
- Postpartum
- Pregnancy
- Prostate surgery
- Restricted mobility
- Sphincteric atony
- Stool impaction
- Tumor
- Vaginitis
- Vesicovaginal fistula
Diagnosis
Shown below is an algorithm summarizing the diagnosis of Urinary incontinence according the the [...] guidelines.
Patients presenting with symptoms of urinary incontinence | |||||||||||||||||||||||||||||||||||||||||
Look for temporary causes
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Look for chronic incontinence
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Based on all the findings arrive at a diagnosis | |||||||||||||||||||||||||||||||||||||||||
"Urge incontinence" ❑Urgency ❑ Frequency ❑Nocturia ❑ Cough stress test: May show delayed leakage after cough ❑ PVR urine< 50ml ❑Variable vol loss seen in voiding dairy | Overflow incontinence ❑No urgency ❑Absence of symptoms on physical activity ❑ Cough stress test:No leakage ❑ PVR urine> 200ml ❑Voiding dairy: varies | Stress incontinence ❑Symptoms seen on coughing, sneezing, exercise, increased intra-abdominal pressure ❑ No nocturia ❑ Cough stress test:Leakage coincides with cough ❑ PVR urine< 50ml ❑Voiding dairy: Small volume leakage | Functional incontinence ❑Cognitive dysfunction, immobility seen ❑ Cough stress test:No leakage ❑ PVR urine: Varies ❑Voiding dairy: Sometimes a pattern seen with incontinence | Mixed incontinence ❑Symptoms with physical activity, urgency noted ❑ Cough stress test:May show leakage ❑ PVR urine<50ml ❑Voiding dairy: Varies | |||||||||||||||||||||||||||||||||||||
Treatment
Treatment for different types of urinary incontinence | |||||||||||||||||||||||||||||||||||||||||
Stress incontinence ❑Lifestyle modifications like weight loss, smoking cessation, decreasing fluid intake, treating constipation if present ❑Pelvic floor muscle (Kegel) exercises that will strengthen the pelvic floor musculature ❑Supervised pelvic floor therapy ❑Vaginal weighted cones ❑Biofeedback ❑ | "Urge incontinence" ❑Urgency ❑ Frequency ❑Nocturia ❑ Cough stress test: May show delayed leakage after cough ❑ PVR urine< 50ml ❑Variable vol loss seen in voiding dairy | D03 | D04 | D05 | |||||||||||||||||||||||||||||||||||||
If above modalities failed | E02 | ||||||||||||||||||||||||||||||||||||||||
E02 | |||||||||||||||||||||||||||||||||||||||||
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
- ↑ "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.