Urinary incontinence. This post will cover the points you need to know for your board exams as well as for teaching residents on the daily rounds. Please don't use the information here to treat your patients.
Urge incontinence is the most common type and characterized by sudden desire to urinate and probably associated with nocturia and frequency. Etiology can be central or peripheral whether autoimmune, vascular or other organic reasons. Treat with pelvic muscle exercises and bladder training. Anticholinergics like Oxybutynin, Imipramine and Tolterodine might help but don't use in during pregnancy or in patients with glaucoma.
Stress incontinence characterized by loss of small amount of urine during effort that increases the intrabdominal pressure like coughing and exercising. Risk factors include pelvic surgery, childbirth and menopause. Treat with lifestyle modification including weight loss, pelvic exercises and biofeedback. Surgery may help non-compliant patients.
Overflow incontinence characterized by constant drippling of urine due to overdistended bladder that can be secondary to obstruction as in BPH or due to neurogenic bladder as in diabetics. Treat intermittent catheterization and surgical correction of the obstruction.
Functional incontinence characterized by passage of urine due to inability to reach the toilet due to physical or mental condition. Treat with scheduled voiding pattern and bedside commode.
A guide for incontinence is available here.
The information in this post is not for patients and shouldn't be used in treating patients. Please refer to your doctor for medical advice.