Chapter 63 Urinary Incontinence: Urge
INTRODUCTION
Description: Urinary incontinence is a sign, a symptom, and a 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.
Predominant Age: Mid-reproductive age and onward. Urge incontinence becomes more common during the 40s and beyond and is most common after menopause.
ETIOLOGY AND PATHOGENESIS
Causes: Allergy, bladder stone, bladder tumor, caffeinism, central nervous system tumors, detrusor muscle instability, interstitial cystitis, multiple sclerosis, Parkinson’s disease, radiation cystitis, radical pelvic surgery, spinal cord injury, urinary tract infections (Urinary tract infections [UTI]; acute or chronic).
CLINICAL CHARACTERISTICS
DIAGNOSTIC APPROACH
Workup and Evaluation
Laboratory: No evaluation indicated. Urinalysis is generally recommended, although results are nonspecific. Abrupt-onset incontinence in older patients should suggest infection, which may be confirmed through urinalysis or culture.
Imaging: Radiographic studies are sometimes performed as a part of complex urodynamics studies but are generally of limited utility.
