Disease Information for Stress incontinence/cysto-urethrocele

Clinical Manifestations
Signs & Symptoms
Marshall Marchetti test/abnormal/sign
Vaginal Urine/Ammonia odor
Difficulty stopping urine flow
Stress incontinence
Urine Incontinence
Uriniferous odor
Demographics & Risk Factors
Past History
Past history/Urinary tract infection
Established Disease Population
Diagnostic Test Results
Other Tests & Procedures
Cystometrics Abnormal
Associated Diseases & Rule outs
Associated Disease & Complications
Urinary tract infection
Disease Synergy - Causes
Synergy/General stress
Drug Therapy - Indication
RX/Solifenacin (VESIcare)

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]


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