URINARY INCONTINENCE

SYMPTOMS

Automatic loss of urine.

  • leakage of urine upon coughing,

sneezing or standing.

  • urgency and inability to delay

urination.

GENERAL CONDITIONS

Urinary incontinence in elderly people is typical, and

Medication can help most patients. Many patients.

Fail to explain their doctors about it.

“if you have a? here is useful information for a problem with urinary leakage or accidents you

CLASSIFICATION

  1. Transient Causes

Use of the mnemonic “DIAPPERS” may be helpful in

remembering the categories of “transient” urinary

incontinence.

  1. Delirium—

Delirium is the most common cause of incontinence in

hospitalized patients; once it clears, incontinence usually

resolves.

  1. Infection-urinary tract infection commonly

causes or contributes to urgency and incontinence.

  1. Atrophic urethritis and vaginitis— urethritis

and vaginitis

  1. Medications- are one of the most

common causes of transient incontinence. Typical offending

agents include potent diuretics, anticholinergics, psychotropics,

opioid analgesics, alpha-blockers (in women),

alpha-agonists (in men), and calcium channel blockers.

  1. Psychological factors—Severe depression with psychomotor

retardation may impede the ability or motivation to

reach a toilet.

  1. Excess urinary output—Excess urinary output may

overwhelm the ability of an older person to reach a toilet in

time.

  1. Stool impaction—This is a common cause of urinary

incontinence in hospitalized or immobile patients.

 CAUSES 

  1. Detrusor overactivity (urge incontinence)—Detrusor

overactivity refers to uninhibited bladder contractions that

cause leakage

  1. Urethral incompetence (stress incontinence)—

Urethral incompetence is the second most common cause

of established urinary incontinence in older women.

  1. Urethral obstruction—Urethral obstruction (due to

prostatic enlargement, urethral stricture, bladder neck contracture,

or prostatic cancer) is a common cause of established

incontinence in older men but is rare in older

women.

  1. Detrusor underactivity (overflow incontinence)—

Detrusor underactivity is the least common cause of incontinence.

It may be idiopathic or due to sacral lower motor

nerve dysfunction.

WHEN TO SEE A DOCTOR?

  • Men with urinary obstruction who do not respond to

medical therapy should be referred to a urologist.

  • Women who do not respond to medical and behavioral

therapy should be referred to a urogynecologist or

urologist.

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