| Urinary Incontinence |
| Type | Pathogenesis | Presentation | Diagnosis | Treatment |
| Stress incontinence | May be secondary to a number of factors such asweakened pelvic floor musclese.g., vaginal deliveriespoor intrinsic sphincter functionincreased urethral mobility | Urinary incontinence with ↑ intra-abdominal pressuree.g., coughing, sneezing, laughing, and physical exertionNo urine loss at nightPhysical exama cystocele may be present | Q-tip test | Strengthening the pelvic floor muscles via Kegel exercisesfirst-lineTopical estrogen for post-menopausal womenPessaryMidurethral sling in patients unresponsive to initial therapy and pessary |
| Urge incontinence | Detrusor muscle overstimulation | Frequent urinary leakage that also occurs at nightdisrupts sleepUrge to urinate and may be unable to reach the bathroom in time | Urodynamic testing | Antimuscarinics e.g., oxybutyninMirabegron |
| Overflow incontinence | Incomplete bladder emptying results in urinary leakage secondary todetrusor muscle underactivity e.g., age, diabetes mellitus, and multiple sclerosisbladder outlet obstructione.g., fibroids and benign prostatic hyperplasia | Urine loss without warning or triggers | Post-void residual volume measurementsUrodynamic testing | Clean intermittent catheterization |
| Mixed Incontinence | – | Symptoms of both stress and urge incontinence | – | Lifestyle modifications and pelvic floor exercises are first-lineIf unresponsive to first-line treatments then therapy is based on the predominant symptoms |
