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Incontinence, Urinary Adult Female

Cara Marshall, MD, Azmina A. Bhayani, MD, MPH and Roopa Chari, MD Reviewed 06/2018
 


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, as only 55% of women who reported at least twice weekly urine leakage on a U.S. survey sought care for their symptoms (2)

  • Age: Stress incontinence is ...

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
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.  ...

ADDITIONAL READING

  • Amundsen CL, Richter HE, Menefee SA, et al. OnabotulinumtoxinA vs sacral neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA. ...

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 UTI or STI by culture.

  • Aggressively treat constipation.

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

  • If lifestyle changes do not work for stress incontinenc...

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