BackTable / Urology / Topic / Condition

Urinary Incontinence

Urinary incontinence involves the involuntary leakage of urine. The types of urinary incontinence can be categorized into stress, urge, functional, mixed, and overflow incontinence. While younger adults can be affected by this condition, it is more prevalent in elderly adults. Patients with mixed urinary incontinence present with a combination of stress and urge urinary incontinence symptoms. This can occur from urethral sphincter and pelvic floor weakness or detrusor overactivity. Bladder irritation and loss of neurologic control are associated with urge urinary incontinence. Overflow urinary incontinence occurs due to an overdistended bladder and is common in men with benign prostatic hyperplasia. Functional urinary incontinence may result from physical barriers to toileting. Patients that are pregnant or have given birth, have diabetes, or have a high body mass index are at an increased risk of incontinence.

Learn more on the BackTable Urology Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Urinary Incontinence and how to build your practice by listening to the BackTable Urology Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.

Ep 148 Defending the Detrusor: A Clinician’s Perspective with Dr. Wayne Kuang

00:00 / 01:04

More about this episode

Stay Up To Date

Follow:

Subscribe:

Urinary Incontinence Diagnosis

Voiding diaries are useful in the diagnosis of incontinence, and a patient’s history will help specify the type of urinary incontinence. A brief questionnaire of the 3 Incontinence Questions (3IQ) is helpful in distinguishing between incontinence and other causes of urine leakage. A physical exam should be performed, and in some cases, a cough stress test and cotton swab test are useful. Additionally, in women, a gynecologic history should be taken and estrogen status should be determined. During perimenopause, atrophic vaginitis and urethritis can contribute to reversible urinary incontinence. Laboratory tests are not always necessary, but they are beneficial for ruling out other conditions.

Urinary Incontinence Podcasts

Listen to leading physicians discuss urinary incontinence on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #182

Evaluating Female Urinary Incontinence: Essential Steps for the Generalist

With contemporary treatment options, your female patients don’t have to live with urinary incontinence! In this crossover episode of BackTable Urology and OBGYN, host Dr. Suzette Sutherland from University of Washington interviews Dr. Sarah Boyles, a urogynecologist at The Oregon Clinic, regarding female urinary incontinence, its diagnostic criteria, and various treatment options to help improve quality of life in the incontinence patient.

Episode #148

Defending the Detrusor: A Clinician’s Perspective

In this episode, Dr. Wayne Kuang (MD for Men LLC in Albuquerque, NM) discusses his initiative to redefine the benign prostatic hyperplasia (BPH) care pathway for patients, doctors, and the healthcare industry.

Episode #110

Neurostimulation for Overactive Bladder: What's New

In this episode of BackTable Urology, Dr. Jose Silva and Dr. Suzette Sutherland, director of Female Urology at the University of Washington in Seattle, discuss new therapies for overactive bladder (OAB).

Episode #74

Men’s Health in a Digital Space

In this episode of BackTable Urology, Dr. Jose Silva and Dr. Petar Bajic speak about various ways that the men’s health field is evolving, such as the rise of direct-to-consumer services, the need for more community urologists, and ways to de-stigmatize common men’s health conditions.

Episode #66

Management of Female Stress Incontinence and Pelvic Organ Prolapse

In this cross-specialty episode of BackTable OBGYN, Dr. Amy Park chats with Dr. Jose Silva, a board certified urologist and co-host of BackTable Urology, about the workup, counseling, and management of urinary incontinence and pelvic organ prolapse.

Episode #60

Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy

In this episode, Dr. Aditya Bagrodia interviews pelvic floor therapist Vanita Gaglani from Vanita’s Rehab about the role of pelvic floor physical therapy for early continence recovery after prostatectomy.

Episode #20

Advanced Treatments for Overactive Bladder (OAB)

Dr. Daniel Hoffman, a urogynecologist specializing in voiding dysfunction, discuss the use of Botox, sacral neuromodulation, and bulking agents in treating overactive bladders. Listen to hear more about patient selection criteria for each treatment, botox and neuromodulation procedure techniques, and treatment side effects and complications.

Episode #14

Patient Selection for GreenLight & Other BPH Treatments

Urologist Dr. Francisco Gelpi discusses surgical treatments for BPH with a special focus on the minimally-invasive GreenLight Laser prostatectomy. Listen to hear more about Dr. Gelpi’s transition from an oncology-focused practice to a BPH-focused practice, initial BPH patient workup , using prostate anatomy to choose a BPH surgical treatment, GreenLight Laser postoperative care, and the importance of BPH patient involvement and expectations.

Episode #11

Evaluation & Management of Post-Prostatectomy Incontinence

Dr. Aditya Bagrodia interviews urologist Dr. Steve Hudak from UT Southwestern Medical Center about post-prostatectomy incontinence. They cover an array of topics including, incontinence evaluation, managing patient expectations, kegel exercises and pelvic floor therapy, and slings vs. artificial urinary sphincters.

Urinary Incontinence Treatment

Treatment and management of incontinence varies with the type of urinary incontinence. For stress urinary incontinence, behavioral therapy, electrical stimulation, and pelvic floor muscle strengthening are common forms of conservative management while alpha-adrenergic agonists are used as a pharmaceutical therapy. Surgical management consists of intravesical balloons, sling procedures, or urethropexy. Urge urinary incontinence does not use mechanical devices, but is otherwise managed similar to stress incontinence. Antimuscarinics are used for pharmacological management. Overflow urinary incontinence is treated with clean intermittent catheterization, alpha-adrenergic antagonists, or a suprapubic catheter. To treat functional urinary incontinence, underlying cognitive causes should be addressed.

Urinary Incontinence Articles

Read our exclusive BackTable Urology Articles for quick insights on urinary incontinence, provided by physicians for physicians.

BPH Patient Education: Focus on Shared Treatment Decisions

How do we best educate our BPH patients on the long-term consequences of insufficient prostate treatment? And how do we enable our patients to decide which BPH treatment option is most appropriate for their individual circumstances? Learn how from ManVsProstate founder Dr. Wayne Kuang.

Bladder vs Prostate: How to Prevent Bladder Complications of BPH

Many BPH patients experience severe late-stage bladder complications, including urinary retention and bladder failure, even when their immediate symptoms are managed according to BPH guidelines. These cases highlight a gap in care where timely surgical deobstruction could have preserved bladder health.

References

[1] Tran, L. N., & Puckett, Y. (2021, August 11). Urinary incontinence. StatPearls [Internet]. Retrieved November 10, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK559095/

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.