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Urge incontinence

Last updated: October 18, 2020

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Urge incontinence is a form of urinary incontinence characterized by a sudden urge to urinate, resulting in involuntary leakage of urine. The condition is caused by sensory or motor dysfunction. It is typically idiopathic but can also result from neurologic conditions such as spinal cord injury and stroke. The prevalence of urge incontinence increases with age, with more women affected than men. The condition is usually diagnosed via a detailed medical history and urodynamic studies. Treatment is conservative and involves the administration of anticholinergics. Surgical options should be considered only as a last resort.

  • Sensory urge incontinence: pathologically increased bladder sensitivity, which results in the reflex action of bladder emptying
  • Motor urge incontinence: autonomous detrusor overactivity

References:[1]

References:[2]

Epidemiological data refers to the US, unless otherwise specified.

References:[3][4]

  • Urinary urgency: sudden urge to urinate
  • Loss of urine without exertion, with urinary tenesmus; frequent episodes, with variable volumes of urine voided each time

See diagnosis of urinary incontinence for general diagnostic measures.

  • Urinary stress test
    • Used to rule out concomitant stress incontinence
    • Negative in individuals who only have urge incontinence (no leakage of urine)
  • Pad test
    • Used to quantify urine leakage over a 1–24-hour period
    • Patients are asked to wear a preweighed sanitary pad, perform certain activities, and drink a certain volume of liquid. The pad is then weighed again to measure urinary leakage.

References:[5]

The differential diagnoses listed here are not exhaustive.

Conservative measures

Conservative measures should first be attempted before considering medical treatment.

Oxybutynin treats Overactive bladder.

Second-line treatment

References:[2][4]

  1. Vasan SS. Urinary Incontinence. Orient Blackswan ; 2002
  2. ACOG. Practice Bulletin No. 155: Urinary Incontinence in Women. Obstetrics & Gynecology. 2015; 126 (5): p.e66-e81. doi: 10.1097/aog.0000000000001148 . | Open in Read by QxMD
  3. Irwin GM. Urinary Incontinence. Primary Care: Clinics in Office Practice. 2019; 46 (2): p.233-242. doi: 10.1016/j.pop.2019.02.004 . | Open in Read by QxMD
  4. Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician. 2013; 87 (8): p.543-550.
  5. Clemens JQ. Urinary incontinence in men. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. http://www.uptodate.com/contents/urinary-incontinence-in-men.Last updated: May 19, 2016. Accessed: May 5, 2017.
  6. Flesh G. Urodynamic Evaluation of Women with Incontinence. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/urodynamic-evaluation-of-women-with-incontinence.Last updated: March 7, 2016. Accessed: January 5, 2018.