urinary incontinence (UI)

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Introduction

Involuntary loss of urine sufficient to be a problem. There are several types of UI, but all are characterized by an inability to restrain or control urinary voiding (see mixed urinary incontinence, nocturnal enuresis, overflow incontinence, stress incontinence, transient urinary incontinence, urge incontinence).

Classification

Etiology

Epidemiology

History

Clinical manifestations

Laboratory

Diagnostic procedures

Radiology

Complications

Management

* PVR = post-void residual

More general terms

More specific terms

Additional terms

References

  1. ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 528-30
  2. ↑ 2.0 2.1 2.2 2.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 17, 19. American College of Physicians, Philadelphia 1998, 2006, 2015, 2021
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. ↑ UCLA Specialty Women's clinic, 2001
  4. ↑ 4.0 4.1 Journal Watch 21(21):168, 2001 Sherburn et al Is incontinence associated with menopause? Obstet Gynecol 98:628, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11576579
  5. ↑ Journal Watch 22(18):142, 2002 Buschsbaum GM et al Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol 100:226, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12151141
  6. ↑ 6.0 6.1 6.2 6.3 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
  7. ↑ Journal Watch 23(20):159, 2003 Grodstein T et al Association of age, race, and obstetric history with urinary symptoms among women in the Nurses' Health Study. Am J Obstet Gynecol 189(Aug):248 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14520212
  8. ↑ 8.0 8.1 8.2 Journal Watch 24(18):146, 2004 Jackson RA, Vittinghoff E, Kanaya AM, Miles TP, Resnick HE, Kritchevsky SB, Simonsick EM, Brown JS; Health, Aging, and Body Composition Study. Urinary incontinence in elderly women: findings from the Health, Aging, and Body Composition Study. Obstet Gynecol. 2004 Aug;104(2):301-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15292003
  9. ↑ 9.0 9.1 Journal Watch 25(17):134, 2005 Subak LL, Whitcomb E, Shen H, Saxton J, Vittinghoff E, Brown JS. Weight loss: a novel and effective treatment for urinary incontinence. J Urol. 2005 Jul;174(1):190-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15947625
    Swithinbank L, Hashim H, Abrams P. The effect of fluid intake on urinary symptoms in women. J Urol. 2005 Jul;174(1):187-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15947624
  10. ↑ Landefeld CS et al, National Institutes of Health state-of-the-science statement: Prevention of fecal and urinary incontinence in adults. Ann Intern Med 2008, 148:449 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18268289 corresponding NGC guideline withdrawn Dec 2013
  11. ↑ Shamliyan TA et al, Systematic review: Randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med 2008, 148:459 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18268288
    Huang AJ [Consensus guidelines] Nonsurgical Treatments for Urinary Incontinence in Women: Summary of Primary Findings and Conclusions. JAMA Intern Med. 2013; 173(15):1463-1464 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23817490
  12. ↑ Minassian VA et al, Urinary incontinence in women: Variation in prevalence estimates and risk factors. Obstet Gynecol 2008, 111:324 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18238969
  13. ↑ 13.0 13.1 13.2 Waetjen LE, Feng WY, Ye J, Johnson WO, Greendale GA et al; Study of Women's Health Across the Nation (SWAN). Factors associated with worsening and improving urinary incontinence across the menopausal transition. Obstet Gynecol. 2008 Mar;111(3):667-77. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18310370
  14. ↑ 14.0 14.1 Subak LL et al, Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women N Engl J Med 360:481-490 January 29, 2009 Number 5 http://content.nejm.org/cgi/content/short/360/5/481 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19179316
  15. ↑ Landefeld CS et al National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008 Mar 18;148(6):449-58. Epub 2008 Feb 11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18268289
  16. ↑ 16.0 16.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
    Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  17. ↑ 17.0 17.1 O'Halloran T et al Urinary Incontinence in Young Nulligravid Women: A Cross-sectional Analysis Annals of Internal Medicine, July 17 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22801671 <Internet> http://annals.org/article.aspx?articleid=1216553
  18. ↑ Ruby CM, Hanlon JT, Boudreau RM et al The effect of medication use on urinary incontinence in community-dwelling elderly women. J Am Geriatr Soc. 2010 Sep;58(9):1715-20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20670377
  19. ↑ DuBeau CE, Kuchel GA, Johnson T et al Incontinence in the frail elderly: report from the 4th International Consultation on Incontinence. Neurourol Urodyn. 2010;29(1):165-78. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20025027
  20. ↑ Goode PS, Burgio KL, Richter HE, Markland AD. Incontinence in older women. JAMA. 2010 Jun 2;303(21):2172-81. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20516418
  21. ↑ 21.0 21.1 21.2 Moore AA NEJM Journal Watch. Women's Health. April 3, 2014 Massachusetts Medical Society http://www.jwatch.org
    Hung KJ et al. Urinary incontinence, depression, and economic outcomes in a cohort of women between the ages of 54 and 65 years. Obstet Gynecol 2014 Apr; 123:822 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24785611 <Internet> http://journals.lww.com/greenjournal/pages/articleviewer.aspx?year=2014&issue=04000&article=00015&type=abstract
  22. ↑ National Institute of Aging
    Urinary incontinence https://www.nia.nih.gov/health/topics/urinary-incontinence
    Urinary Incontinence in Older Adults https://www.nia.nih.gov/health/urinary-incontinence-older-adults
  23. ↑ Evaluation and Management of Urinary Incontinence: recommendations from the Brigham and Women's Hospital, Finnish Medical Society, The John A. Hartford Foundation Institute for Geriatric Nursing, Scottish Intercollegiate Guidelines Network, and the Singapore Ministry of Health. http://www.guideline.gov/Compare/comparison.aspx?file=INCONTINENCE1.inc
  24. ↑ DuBeau CE. Therapeutic/pharmacologic approaches to urinary incontinence in older adults. Clin Pharmacol Ther. 2009 Jan;85(1):98-102. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19037201
  25. ↑ Fung CH, Spencer B, Eslami M, Crandall C. Quality indicators for the screening and care of urinary incontinence in vulnerable elders. J Am Geriatr Soc. 2007 Oct;55 Suppl 2:S443-9. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17910569
  26. ↑ Qaseem A, Dallas P, Forciea MA et al Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2014;161(6):429-440 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25222388 <Internet> http://annals.org/article.aspx?articleid=1905131
  27. ↑ Wood LN, Anger JT. Urinary incontinence in women. BMJ. 2014;349:g4531. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25225003
  28. ↑ Markland AD, Vaughan CP, Johnson TM et al Incontinence. Med Clin North Am. 2011 May;95(3):539-54, x-xi. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21549877
  29. ↑ Cameron AP, Heidelbaugh JJ, Jimbo M. Diagnosis and office-based treatment of urinary incontinence in adults. Part one: diagnosis and testing. Ther Adv Urol. 2013 Aug;5(4):181-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23904857 Free PMC Article
    Cameron AP, Jimbo M, Heidelbaugh JJ. Diagnosis and office-based treatment of urinary incontinence in adults. Part two: treatment. Ther Adv Urol. 2013 Aug;5(4):189-200. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23904858 Free PMC
  30. ↑ DuBeau CE. Therapeutic/pharmacologic approaches to urinary incontinence in older adults. Clin Pharmacol Ther. 2009 Jan;85(1):98-102. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19037201
  31. ↑ Hersh L, Salzman B. Clinical management of urinary incontinence in women. Am Fam Physician. 2013 May 1;87(9):634-40. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23668526 Free Article
  32. ↑ Ayeleke RO, Hay-Smith EJ, Omar MI. Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women. Cochrane Database Syst Rev. 2015 Nov 3;(11):CD010551. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26526663
  33. ↑ 33.0 33.1 Nambiar AK, Bosch R, Cruz F et al EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence. Eur Urol. 2018 Feb 2. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29398262 <Internet> http://www.europeanurology.com/article/S0302-2838(18)30002-2/fulltext
  34. ↑ 34.0 34.1 O'Reilly N, Nelson HD, Conry JM et al Screening for Urinary Incontinence in Women: A Recommendation From the Women's Preventive Services Initiative. Ann Intern Med. Aug 14, 2018. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30105360 <Internet> http://annals.org/aim/fullarticle/2697085/screening-urinary-incontinence-women-recommendation-from-women-s-preventive-services
    Nelson HD, Cantor A, Pappas M, Miller L. Screening for Urinary Incontinence in Women: A Systematic Review for the Women's Preventive Services Initiative. Ann Intern Med. Aug 14, 2018. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30105353 <Internet> http://annals.org/aim/article-abstract/2697084/screening-urinary-incontinence-women-systematic-review-women-s-preventive-services
    Bell RJ, Davis SR. Routine Screening for Urinary Incontinence in Women: Caution Advised. Ann Intern Med. Aug 14, 2018. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30105377 <Internet> http://annals.org/aim/article-abstract/2697086/routine-screening-urinary-incontinence-women-caution-advised
  35. ↑ Judge DE Urinary Incontinence: Yes, It Can Be Treated. NEJM Journal Watch. Jan 22, 2019 Massachusetts Medical Society (subscription needed) http://www.jwatch.org https://www.jwatch.org/na48165/2019/01/22/urinary-incontinence-yes-it-can-be-treated
    Fitzgerald JJ, Iglesia CB Treatment Options for Women with Urinary Incontinence. NEJM Journal Watch. Jan 22, 2019 Massachusetts Medical Society (subscription needed) http://www.jwatch.org https://www.jwatch.org/na48035/2019/01/22/treatment-options-women-with-urinary-incontinence
  36. ↑ 36.0 36.1 Balk EM, Rofeberg VN, Adam GP et al Pharmacologic and Nonpharmacologic Treatments for Urinary Incontinence in Women: A Systematic Review and Network Meta-analysis of Clinical Outcomes Ann Intern Med. 2019. March 19. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30884526 https://annals.org/aim/article-abstract/2728712/pharmacologic-nonpharmacologic-treatments-urinary-incontinence-women-systematic-review-network-meta
  37. ↑ 37.0 37.1 Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30288727 PMCID: PMC6516955 Free PMC article https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005654.pub4/full
  38. ↑ Talebraza S et al Geriatrics Evaluation & Management Tools American Geriatrics Society. 2021 https://geriatricscareonline.org/ProductAbstract/geriatrics-evaluation-management-tools/B007/
  39. ↑ National Poll on Healthy Aging Urinary Incontinence: An Inevitable Part of Aging? http://www.healthyagingpoll.org/sites/default/files/2018-11/NPHA_Incontinence-Report_FINAL-110118.pdf

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