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General Medicine

Incontinence, Urinary Adult Male

William Dabbs, MD, Justin Jenkins, DO, MBA and Taylor Wright, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Urinary incontinence (UI) is a pathologic condition of an acute or chronic nature that refers to the involuntary loss of urine leading to medical, financial, social, or hygienic prob...

DIAGNOSIS

HISTORY

  • Voiding symptoms

    • Duration and characteristics of incontinence

    • Precipitants, severity, timing, and associated symptoms (BPH, fluid intake, etc.)

    • Use of pads, briefs, diapers

    • Alteration in ...

TREATMENT

Conservative, nonmedication interventions, such as behavioral modification, timed voiding, bladder training, and pelvic floor muscle training, should be considered first-line therapies, prio...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Must monitor residual volume after voiding in patients taking anticholinergic medications; monitor side effects. 

PROGNOSIS

Continence can be impr...

REFERENCES

1
Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician.  2013;87(8):543–550. [View Abstract on OvidMedline]
2
Gravas A, Bachmann A, Descazeaud A, et al. EAU Guidel...

ADDITIONAL READING

  • Bauer RM, Bastian PJ, Gozzi C, et al. Postprostatectomy incontinence: all about diagnosis and management. Eur Urol.  2009;55(2):322–333. [View Abstract on OvidMedline]

  • Markland ...

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

  • Think “outside” the lower urinary tract: Comorbid medical illness and impairments are independently associated with UI; treat contributing comorbidities and rule out secondary causes.

  • A...

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Figure 29.4. Surgical therapy for urinary incontinence. (A1–A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior vaginal wall is opened and undermined. (A2) Paraurethral tissue lateral to the urethrovesical (UV) junction is sutured. (A3) This creates a firm bar of tissue that supports the UV junction. (B1–B4) Retropubic suspension procedures, the Marshall-Marchetti-Krantz procedure. (B1) The suture is placed in the per...
Figure 29.4. Surgical therapy for urinary incontinence. (A1–A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior va...
Figure 29.4. Pessaries. (A) Inflatable. (B) Doughnut. (C) Smith-Hodge. (D) Cube.
Figure 29.4. Pessaries. (A) Inflatable. (B) Doughnut. (C) Smith-Hodge. (D) Cube.
Figure 29.5. Surgical therapy for urinary incontinence. (A1-A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior vaginal wall is opened and undermined. (A2) Paraurethral tissue lateral to the urethrovesical (UV) junction is sutured. (A3) This creates a firm bar of tissue that supports the UV junction. (B1-B4) Retropubic suspension procedures, the Marshall-Marchetti-Krantz procedure. (B1) The suture is placed in the periurethral tissue and then into the pubic periost...
Figure 29.5. Surgical therapy for urinary incontinence. (A1-A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior v...
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