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URINARY INCONTINENCE CLASSIFICATION
Category: Urology
Abstract : Urinary incontinence - Definition Urinary incontinence (UI) is the complaint of any involuntary leakage of urine.1 It results from a failure to store urine during the filling phase of the bladder due to abnormality of bladder smooth muscle or the urethral sphincter. Urine loss is either urethral or extra-urethral (secondary to anatomical abnormalities including ectopic ureters, rectovesical or
Urinary incontinence - Definition
Urinary incontinence (UI) is the complaint of any involuntary leakage of urine.1 It results from a failure to store urine during the filling phase of the bladder due to abnormality of bladder smooth muscle or the urethral sphincter. Urine loss is either urethral or extra-urethral (secondary to anatomical abnormalities including ectopic ureters, rectovesical or vesicovaginal fistulae).
Prevalence
It affects about 3.5 million people in the UK, females > males, and increases with age2.
Urinary incontinence - Classification
Stress urinary incontinence (SUI) is involuntary urinary leakage on effort, exertion, sneezing, or coughing, due to hypermobility of the bladder base, pelvic floor, and/or intrinsic urethral sphincter deficiencies.
Type 0 : report of urinary incontinence, but without clinical signs.
Type I : leakage that occurs during stress with <2cm descent of the bladder base below the upper border of the symphysis pubis.
Type II : leakage on stress accompanied by marked bladder base descent (>2cm) that occurs only during stress (IIa) or is permanently present (IIb).
Type III : bladder neck and proximal urethra are already open at rest (with or without descent). Also known as intrinsic sphincter deficiency (ISD).
Urge urinary incontinence (UUI) is involuntary urine leakage accompanied by, or immediately preceded by a sudden, strong desire to void (urgency). It is a component of the overactive bladder syndrome.
Overflow incontinence is leakage of urine when the bladder is abnormally distended with large residual volumes. Typically, men present with chronic urinary retention and dribbling incontinence. This can lead to back pressure on the kidneys and renal failure in 30% of patients.
Nocturnal enuresis describes any involuntary loss of urine during sleep. The prevalence in adults is 0.5%. Approximately 750,000 children over 7 years will regularly wet the bed. Childhood enuresis can be further classified into primary types (never been dry for longer than a 6-month period) or secondary (the re-emergence of bed wetting after a period of being dry for at least 6 - 12 months).
Post-micturition dribble is the complaint of a dribbling loss of urine that occurs after voiding. It predominantly affects males, and is due to pooling of urine in the bulbous urethra after voiding. It affects approximately 20% of healthy adults,3 and 60 - 70% of those with existent LUTS.
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