Urinary incontinence: the basics

Urinary incontinence (UI) is a widely prevalent problem that affects people of all ages and levels of physical health, both in healthcare settings and in the community. Contributing to the problem are that many practitioners remain uneducated about this condition, individuals are often too ashamed or embarrassed to seek professional help, and there are significant variations in diagnostic and treatment practices. Five types of UI are stress, urge, overflow, functional and manufactured incontinence. Stress, urge and overflow are caused by factors within the urinary tract and will be concentrated on in this article. To diagnose UI a three-part assessment should be conducted, including the patient history, physical examination, and urinalysis. A behavioral program should be designed which incorporates identification and education for both patient and clinician. Treatment options include pelvic floor exercises (Kegel), vaginal cones, bladder training (retraining), habit training (timed voiding), electrostimulation and biofeedback, clean intermittent catheterization, indwelling catheters, medications, collagen injections, surgery, and absorption products. Most patients can be helped dramatically or cured with the appropriate treatment.