Urinary Incontinence

Introduction

Urinary incontinence is defined as the involuntary loss of urine that is sufficient to be a problem to the patient, and may occur in males and females. A complete history and physical examination are essential elements of the urologic evaluation of urinary incontinence. Additional testing such as a complex urodynamic study may be required to better characterize the nature of urinary leakage and overall bladder function. In this study, the bladder is filled at a predetermined rate and bladder pressures are continuously measured. The patient may be asked to cough and strain during the study, and will often be filled to measure the bladder's capacity, ability to empty, and the voiding pressure.

Stress Urinary Incontinence

Stress incontinence is the loss of urine with increases in intra-abdominal pressure as with cough or sneezing. This may be secondary to urethral sphinter insufficiency, as in anatomic prolapse or sphinter injury. When sophisticated urinary bladder pressure studies confirm stress urinary incontinence, a recommendation for a bladder neck suspension procedure may be offered in cases of significant symptoms and a high level of bother.

Urgency Urinary Incontinence

Urge incontinence is defined as the loss of urine associated with the urgent need to urinate. A patient will state that "I just can't hold it when I have to go". In many cases, sophisticated bladder testing will find no significant underlying disorder, and a patient will be treated with medical therapy. It is important to rule out related neurologic and medical disorders.