Urinary incontinence differential diagnosis

Urinary incontinence Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Urinary incontinence from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-Ray Findings
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Urinary incontinence differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Urinary incontinence differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Urinary incontinence differential diagnosis
CDC on Urinary incontinence differential diagnosis
Urinary incontinence differential diagnosis in the news
Blogs on Urinary incontinence differential diagnosis
Directions to Hospitals Treating Urinary incontinence
Risk calculators and risk factors for Urinary incontinence differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Differential diagnosis

Type Of Incontinence	Causes	Prevalence	Pathophysiology	History Findings	Signs and symptoms						Management
					Urgency	Frequency (> 8 times/day)	Dribbling of urine	Amount of dribbling with each episode of incontinence	Ability hold urge	Nocturia
Urge incontinence (detrusor instability)	Stroke Alzheimer's disease Parkinson's disease Benign prostatic hyperplasia (BPH)	9% in women age 40-44 years 31% in women older than 75 years 42% in men older than 75 years	Detrusor overactivity Increased parasympathetic drive to the bladder (S2-S4)	Variable amount of urine loss; ranging from small volumes to complete emptying of the bladder	+	+	-	Large volume	-	++	Pelvic floor excercises Oxybutynin Tolterodine
Stress incontinence	Genitourinary surgical procedures Multiple childbirths	25-45% in women > 30 years	Weakness of the uretheral sphincter Weakness of the pelvic floor muscles	Patient recognizes which activities promote incontinence Incontinence with cough, sneezing, straining	-	-	+	Small volume	+	+/-	Pelvic floor excercises Alpha agonists Topical estrogen cream
Overflow incontinence	Benign prostatic hyperplasia Fecal impaction	5% of patients with chronic incontinence More common in males	Overdistension of the bladder Impaired bladder contractility Bladder outlet obstruction (BOO)	Poor bladder emptying Post-void urine volume > 200-300 ml	-	-	+	Small volume	+	+	Alpha-adrenergic blockers: Tamsulosin Terazosin Catheterization Diversion
Mixed incontinence (urge and stress)	Stroke Alzheimer's disease Parkinson's disease Benign prostatic hyperplasia (BPH) Genitourinary surgical procedures Multiple childbirths	-	Combined urge and stress incontinence	Patient able to determine the pre-dominant symptoms	+	+/-	+	Variable volume	+/-	+/-	Symptomatic management
Functional incontinence	Altered mental status	-	Inability to reach the toilet to urinate Environmental barriers Physical barriers	Immobility Lower urinary tract deficits	-	-	+	Variable volume	+	+	Cause-dependent