Urinary Incontinence
Urinary incontinence is involuntary urine leakage; the pattern—effort-related, urgency-related, mixed, continuous or dribbling from retention—identifies the mechanism and determines whether pelvic-floor training, bladder training, medicines, catheterisation or specialist treatment is appropriate.
Definition
Urinary incontinence is the involuntary loss of urine. It is classified into stress incontinence, urgency incontinence/overactive bladder, mixed incontinence, overflow incontinence from chronic retention, and continuous leakage such as from a fistula or severe functional impairment.
First principles
Classify the leakage before prescribing
Stress incontinence is leakage with cough, movement or exertion because outlet support or sphincter competence is insufficient. Urgency incontinence follows a sudden compelling desire to void, usually as part of overactive bladder. Mixed incontinence contains both patterns. Continuous leakage or dribbling with a palpable bladder suggests fistula or chronic retention, and antimuscarinic treatment can worsen retention.
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