Urinary incontinence - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2022-12-14T15:45:21Z

Differential Diagnosis

← Older revision		Revision as of 15:45, 14 December 2022
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	*Medication toxicity		*Medication toxicity
	*[[Constipation]]		*[[Constipation]]



	===Transient incontinence===		===Transient incontinence===

Rossdonaldson1: /* Differential Diagnosis */

2022-12-14T15:45:02Z

Differential Diagnosis

← Older revision		Revision as of 15:45, 14 December 2022
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	~~==Differential Diagnosis==~~
	===Transient incontinence===		===Transient incontinence===
	*[[Delirium]]		*[[Delirium]]

Rossdonaldson1 at 15:44, 14 December 2022

2022-12-14T15:44:28Z

← Older revision		Revision as of 15:44, 14 December 2022
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	==Background==		==Background==
			*Defined as the involuntary leakage of urine
			*Estimated prevalence of ~40% of women and ~21% of men older than 65 years of age<ref>Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012 Aug;23(8):1087-93. doi: 10.1007/s00192-012-1743-x. Epub 2012 Apr 12. PMID: 22527544; PMCID: PMC3905313.</ref><ref>Shamliyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male urinary incontinence: prevalence, risk factors, and preventive interventions. Rev Urol. 2009 Summer;11(3):145-65. PMID: 19918340; PMCID: PMC2777062.</ref>
			*Can have profound impact on quality of life, sexual dysfunction, and morbidity (e.g., perineal infections, falls)

			==Clinical Features==
			*Three main classifications of incontinence: Stress, Urgency, Overflow
			**Stress: Involuntary leakage of urine that occurs with increases in intraabdominal pressure<ref>Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ; Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213-40. doi: 10.1002/nau.20870. PMID: 20025020.</ref>
			**Urgency: Leakage accompanied by or immediately preceded by urgency<ref>Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ; Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213-40. doi: 10.1002/nau.20870. PMID: 20025020.</ref>
			**Overflow: Continuous leakage or dribbling in the setting of incomplete bladder emptying
			*Mixed urinary incontinence: Symptoms of both stress and urgency

			==Differential Diagnosis==
			*[[Vaginal atrophy]]
			*[[Urinary tract infection]]
			*Urogenital fistula
			*Neurologic disorders
			*Medication toxicity
			*[[Constipation]]

	~~==Clinical Features==~~


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	==Evaluation==		==Evaluation==
			===Workup===
			*[[Urinalysis]]
			*[[Urine culture]]

			===Diagnosis===
			*Clinical tests
			**Bladder stress test
			***PPV is ~78-97% for stress or mixed urinary incontinence<ref>Harvey MA, Versi E. Predictive value of clinical evaluation of stress urinary incontinence: a summary of the published literature. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(1):31-7. doi: 10.1007/s001920170091. PMID: 11294529.</ref>
			**Post-void residual:
			***>150cc or >1/3 total voided volume should be evaluated for voiding dysfunction

	==Management==		==Management==
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	==Disposition==		==Disposition==
			*Discharge with PMD follow-up
			*Will rarely require specialist referral

	==See Also==		==See Also==
			*[[Urinary incontinence]]

	==External Links==		==External Links==


	==References==		==References==
	<references/>		<references/>
	[[Category:Symptoms]] [[Category:Urology]]		[[Category:Symptoms]] [[Category:Urology]]

ClaireLewis at 15:46, 23 October 2019

2019-10-23T15:46:09Z

← Older revision		Revision as of 15:46, 23 October 2019
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	**[[UTI]]		**[[UTI]]
	**[[Loa loa]]		**[[Loa loa]]
	*Atrophic vaginitis/urethritis		*[[Atrophic vaginitis]]/[[urethritis]]
	*Drugs		*Drugs
	**[[Anticholinergics]]		**[[Anticholinergics]]

ClaireLewis at 14:46, 8 September 2019

2019-09-08T14:46:52Z

← Older revision		Revision as of 14:46, 8 September 2019
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	==References==		==References==
	<references/>		<references/>
			[[Category:Symptoms]] [[Category:Urology]]

ClaireLewis: Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ===Transient incontinence=== Delirium Infection UTI Loa loa *Atrophic vaginitis/urethriti..."

2019-09-05T14:17:19Z

Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ===Transient incontinence=== *Delirium *Infection **UTI **Loa loa *Atrophic vaginitis/urethriti..."

New page

==Background==

==Clinical Features==

==Differential Diagnosis==
===Transient incontinence===
*[[Delirium]]
*Infection
**[[UTI]]
**[[Loa loa]]
*Atrophic vaginitis/urethritis
*Drugs
**[[Anticholinergics]]
**[[Diuretics]]
**[[Hypnotics]]
*Psychiatric disorders (e.g. [[psychosis]])
*[[Polyuria]]
*Restricted mobility
*[[Fecal impaction]]

===Established incontinence===
*Detrusor overactivity ("urge" incontinence or "overactive" bladder)
*Urethral incompetence (stress incontinence, e.g. multiparity, pelvic surgery)
*Urethral obstruction (e.g. BPH)
*Detrusor underactivity (overflow)
**Spinal cord dysfunction/neurogenic
***[[Transverse myelitis]]
***[[Decompression sickness]]
***[[Cerebral edema in DKA]]
***[[Normal pressure hydrocephalus]]
***[[Cauda equina syndrome]]
**[[Incarcerated uterus]]

==Evaluation==

==Management==

==Disposition==

==See Also==

==External Links==

==References==
<references/>

Urinary incontinence - Revision history

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1 at 15:44, 14 December 2022

ClaireLewis at 15:46, 23 October 2019

ClaireLewis at 14:46, 8 September 2019

ClaireLewis: Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ===Transient incontinence=== *Delirium *Infection **UTI **Loa loa *Atrophic vaginitis/urethriti..."

ClaireLewis: Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ===Transient incontinence=== Delirium Infection UTI Loa loa *Atrophic vaginitis/urethriti..."