Urinary Incontinence: Urge

Introduction

• Description: Urinary incontinence is a sign, symptom, and disease all at the same time. Urge incontinence is the involuntary loss of urine accompanied by a sense of urgency or impending loss and is associated with increased bladder activity.

• Prevalence: Urge incontinence accounts for 35% of patients with incontinence.

• Predominant Age: Mid-reproductive age and older. Urge incontinence becomes more common during the 40s and beyond and is most common after menopause.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Allergy, bladder stone, bladder tumor, caffeinism, central nervous system tumors, detrusor muscle instability, interstitial cystitis, multiple sclerosis, Parkinson disease, radiation cystitis, radical pelvic surgery, spinal cord injury, urinary tract infections (urinary tract infections [UTIs]; acute or chronic).

• Risk Factors: Frequent UTIs.

Signs and Symptoms

• Reduced bladder capacity and early, intense sensations of bladder fullness

• Spontaneous and uninhibitable contractions of the bladder muscles, resulting in large-volume, uncontrolled urine loss

• Loss possibly provoked by activities such as hand washing or a change in position or posture or after (not during) changes in intraabdominal pressure such as a cough or sneeze

Diagnostic Approach