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Incontinence, Urinary Adult Female

Cara Marshall, MD, Chelsea Harris, MD and Julia Tse, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Urinary incontinence: involuntary loss of urine

  • Stress incontinence: associated with increased intra-abdominal pressure, such as coughing, laughing, sneezing, or exertion

  • Urge incontin...

DIAGNOSIS

HISTORY

  • Important to screen for symptoms because only 45% of women who reported at least twice weekly urine leakage on a U.S. survey sought care for their symptoms (2)

  • Age: Stress incontinence...

TREATMENT

GENERAL MEASURES

  • Treat correctable causes (e.g., UTI).

  • Encourage weight loss in obese patients.

  • Aggressively correct constipation.

  • Treat mixed for primary symptom type (5)[C].

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Periodic long-term follow-up with outcome-based questionnaire surveys 

PATIENT EDUCATION

Instructions on self-care and warning signs are available...

REFERENCES

1
Lukacz ES, Santiago-Lastra Y, Albo ME, et al. Urinary incontinence in women: a review. JAMA.  2017;318(16):1592–1604. [View Abstract on OvidMedline]
2
Committee on Practice Bulletins—Gy...

ADDITIONAL READING

  • Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol.  2012;188(Suppl 6):2455–2563. [...

CODES

ICD10

  • R32 Unspecified urinary incontinence

  • N39.3 Stress incontinence (female) (male)

  • N39.41 Urge incontinence

  • N39.46 Mixed incontinence

  • N39.45 Continuous leakage

  • N39.42 Incontinence without sensory aw...

CLINICAL PEARLS

  • Rule out infection (UTI or STI) and hematuria.

  • Aggressively treat constipation.

  • Try lifestyle changes first for all types of urinary incontinence.

  • If lifestyle changes do not work for str...

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