Urinary incontinence overview: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(15 intermediate revisions by the same user not shown)
Line 12: Line 12:
Urinary incontinence: Unintentional loss of urine. Inability to hold urine in the [[bladder]] due to loss of voluntary control over the bladder (detrusor) muscle and/or urinary sphincters resulting in the involuntary passage of urine.  
Urinary incontinence: Unintentional loss of urine. Inability to hold urine in the [[bladder]] due to loss of voluntary control over the bladder (detrusor) muscle and/or urinary sphincters resulting in the involuntary passage of urine.  
In this article, the term "incontinence" will be used to mean urinary incontinence. See also [[fecal incontinence]].
In this article, the term "incontinence" will be used to mean urinary incontinence. See also [[fecal incontinence]].
==Classification==
Urinary incontinence can be broadly classified into 5 major types. They are stress incontinence, urge incontinence, overflow incontinence, mixed incontinence, functional incontinence.
==Causes==
Urinary incontinence is commonly caused by conditions affecting [[bladder]] integrity, including [[infections]], [[neoplasms]], [[surgical]] procedures, and internal sources of trauma, such as [[nutrition]] and water intake. It can also be caused by [[congenital]] and [[acquired]] [[neurological]], [[muscular]], and [[renal]] conditions.
== Pathophysiology==
Continence and [[micturition]] involve a balance between outlet (urethra) and bladder [[detrusor]] muscle activity. Lower urinary tract function is often divided into filling and voiding phases.  Normally as the bladder fills the detrusor is compliant - stretching and increasing the volume it holds - without any unpleasant sensation and the outlet is closed.  At a socially acceptable time and place to void the bladder (detrusor) contracts and the outlet relaxes and flow ensues. Any perturbation in that balance can lead to voiding dysfunction or incontinence.  Abnormal detrusor muscle activity or hypersensitivity of the bladder can lead to urge incontinence.  An incompetent outlet can lead to stress incontinence.  A bladder that cannot contract may lead to overflow incontinence.
==Differential diagnosis==
Urinary incontinence may have different etiologies depending upon the underlying dysfunction. The various types of urinary incontinence should be differentiated from each other and also urinary incontinence should be differentiated from other conditions like stroke, multiple sclerosis, parkinson's disease, fecal impaction, rectal prolapse etc.
==Epidemiology and demographics==
==Risk Factors==
==Screening==
==Natural history, complications and prognosis==
Common complications of [[urinary incontinence]] include increased risk of falling and [[fractures]], [[urinary tract infection]], sleep disorders, [[depression]]. The prognosis associated with [[urinary incontinence]] depends on the underlying cause and associated conditions such as accurate diagnosis, and proper treatment.


==Diagnosis==
==Diagnosis==
===Diagnostic study of choice===
===History and symptoms===


===Physical Examination===
===Physical Examination===
The [[physical examination]] will focus on looking for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.
The [[physical examination]] will focus on looking for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.
===Laboratory findings===
===Electrocardiogram===
===X-ray===
===Echocardiography and ultrasound===
===CT scan===
===MRI===
===Other imaging findings===
===Other diagnostic studies===
===Medical therapy===
Medications can reduce many types of urine leakage. Some drugs inhibit contractions of an overactive bladder. Others relax muscles, leading to more complete bladder emptying during urination. Some drugs tighten muscles at the bladder neck and urethra, preventing leakage. And some, especially hormones such as estrogen, are believed to cause muscles involved in urination to function normally.In vaginal atrophy - topical or vaginal [[estrogen]]s; [[tolterodine]], [[oxybutynin]], [[propantheline]], [[darifenacin]], [[solifenacin]], trospium in urge incontinence, [[imipramine]] in mixed and stress urinary incontinence, [[pseudoephedrine]] and [[duloxetine]] in stress urinary incontinence


==References==
==References==

Latest revision as of 02:47, 8 March 2021

https://https://www.youtube.com/watch?v=vsLBApSlPMo&t=11s |350}}

Urinary incontinence Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Urinary incontinence from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray Findings

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Urinary incontinence overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Urinary incontinence overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Urinary incontinence overview

CDC on Urinary incontinence overview

Urinary incontinence overview in the news

Blogs on Urinary incontinence overview

Directions to Hospitals Treating Urinary incontinence

Risk calculators and risk factors for Urinary incontinence overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Urinary incontinence: Unintentional loss of urine. Inability to hold urine in the bladder due to loss of voluntary control over the bladder (detrusor) muscle and/or urinary sphincters resulting in the involuntary passage of urine. In this article, the term "incontinence" will be used to mean urinary incontinence. See also fecal incontinence.

Classification

Urinary incontinence can be broadly classified into 5 major types. They are stress incontinence, urge incontinence, overflow incontinence, mixed incontinence, functional incontinence.

Causes

Urinary incontinence is commonly caused by conditions affecting bladder integrity, including infections, neoplasms, surgical procedures, and internal sources of trauma, such as nutrition and water intake. It can also be caused by congenital and acquired neurological, muscular, and renal conditions.

Pathophysiology

Continence and micturition involve a balance between outlet (urethra) and bladder detrusor muscle activity. Lower urinary tract function is often divided into filling and voiding phases. Normally as the bladder fills the detrusor is compliant - stretching and increasing the volume it holds - without any unpleasant sensation and the outlet is closed. At a socially acceptable time and place to void the bladder (detrusor) contracts and the outlet relaxes and flow ensues. Any perturbation in that balance can lead to voiding dysfunction or incontinence. Abnormal detrusor muscle activity or hypersensitivity of the bladder can lead to urge incontinence. An incompetent outlet can lead to stress incontinence. A bladder that cannot contract may lead to overflow incontinence.

Differential diagnosis

Urinary incontinence may have different etiologies depending upon the underlying dysfunction. The various types of urinary incontinence should be differentiated from each other and also urinary incontinence should be differentiated from other conditions like stroke, multiple sclerosis, parkinson's disease, fecal impaction, rectal prolapse etc.

Epidemiology and demographics

Risk Factors

Screening

Natural history, complications and prognosis

Common complications of urinary incontinence include increased risk of falling and fractures, urinary tract infection, sleep disorders, depression. The prognosis associated with urinary incontinence depends on the underlying cause and associated conditions such as accurate diagnosis, and proper treatment.

Diagnosis

Diagnostic study of choice

History and symptoms

Physical Examination

The physical examination will focus on looking for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.

Laboratory findings

Electrocardiogram

X-ray

Echocardiography and ultrasound

CT scan

MRI

Other imaging findings

Other diagnostic studies

Medical therapy

Medications can reduce many types of urine leakage. Some drugs inhibit contractions of an overactive bladder. Others relax muscles, leading to more complete bladder emptying during urination. Some drugs tighten muscles at the bladder neck and urethra, preventing leakage. And some, especially hormones such as estrogen, are believed to cause muscles involved in urination to function normally.In vaginal atrophy - topical or vaginal estrogens; tolterodine, oxybutynin, propantheline, darifenacin, solifenacin, trospium in urge incontinence, imipramine in mixed and stress urinary incontinence, pseudoephedrine and duloxetine in stress urinary incontinence

References

Template:WH Template:WS