- Clinical science
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.
- Prevalence increases with age
- Sex: ♀ > ♂
Epidemiological data refers to the US, unless otherwise specified.
- Idiopathic (most common)
- Neurological conditions; : lesions above the brain stem, spinal cord injury, stroke, Parkinson disease, dementia, and multiple sclerosis
- Genitourinary conditions: bladder cancer, inflammation, or renal stones
- Risk factors include:
- See also “Etiology” of .
- See for general diagnostic measures.
- Urinary stress test: : no leakage of urine in pure urge incontinence
- 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.
The differential diagnoses listed here are not exhaustive.
Conservative measures should first be attempted before considering medical treatment.
- Behavioral therapies, exercises, lifestyle medications (see )
- First-line are anticholinergics, including oxybutynin, tolterodine, solifenacin, trospium, and darifenacin
- Alternatives or combined administration
- Endoscopic injection of botulinum toxin at different points in the bladder wall
- Sacral nerve stimulation
- Last resort
- Augmentation cystoplasty
- In severe cases that show no response to other modes of therapy: diversion of urinal flow