Disease Information for Bladder incontinence

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Clinical Manifestations
Signs & Symptoms
Vaginal Urine/Ammonia odor
Bed wetting
Overflow incontinence
Stress incontinence
Urinary incontinence in Children
Urinary Incontinence in Elderly
Urine Frequency
Urine Incontinence
Diagnostic Test Results
Other Tests & Procedures
Cystometrics Abnormal
Associated Diseases & Rule outs
Associated Disease & Complications
Eneuresis Bed Wetting
Urinary tract infection
Synonyms
Synonym
Absence of bladder continence, Bladder continence absence, Bladder incontinence, Bladder incontinent, Bladder incontinent (finding), bladder weak, incontinence, Incontinence (Urinary), Incontinence of urine, Incontinence of urine (situation), incontinence urinary, Incontinence urine, incontinent of urine, Involuntary urination, Lack of bladder control, Leaking of urine, Loss of bladder control, Micturition involuntary, UI Urinary incontinence, Unable (to) hold urine, Unable prevent bladder emptyng, Unable to control bladder, Unable to hold fluids, Unable to hold urine, Unable to prevent bladder emptying, Unspecified urinary incontinence, URINARY BLADDER INCONTINENCE, Urinary incontinence, Urinary incontinence (finding), Urinary incontinence unspecified, Urination involuntary, urine incontinence, weak bladder, RX/Fesoterodine (Toviaz)
Treatment
Drug Therapy - Indication
RX/Darifenacin (Enablex)
RX/Oxybutynin (Ditropan)
RX/Solifenacin (VESIcare)
RX/Tolterodine (Detrol)
RX/Trospium (Sanctura)
Other Treatments
TX/Bladder Training
Definition

The basic evaluation of incontinent patients includes a focused history (which can be enhanced by a voiding diary), a targeted physical examination, urinalysis, and a postvoid residual determination; Postvoid residual determination is essential in almost all patients because the symptoms of overflow incontinence are nonspecific, and the physical examination alone is not sensitive in detecting significant urinary retention (ie, postvoid residual >200 mL); A portable ultrasound device is available and can provide noninvasively an accurate estimate of bladder volume; The objectives of this basic evaluation are to (1) identify potentially reversible factors ; (2) determine, if possible, the most likely types and underlying causes ; and (3) identify patients who may require further evaluation.

Selected patients may benefit from further urologic, gynecologic, and urodynamic evaluation; Patients with sterile hematuria should be considered for urine cytology and cystoscopy; Women with severe pelvic prolapse should be referred to a gynecologist for consideration of pessary placement or surgery; Women or men with severe stress incontinence should be considered for referral for surgical intervention; Patients with significant urinary retention, patients with a neurologic disorder that may underlie the incontinence, and patients who fail initial treatment interventions should be considered for urodynamic evaluation; Complex urodynamic tests (multichannel cystometry, pressure-flow studies, leak point pressure) can assist in determining the precise underlying lower urinary tract pathophysiology; [Cecil 2004]

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External Links Related to Bladder incontinence
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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