Stress Incontinence

This chapter deals with stress urinary incontinence (SUI). It provides the background information of the disorder, and discusses its prevention, diagnosis, treatment, prognosis, and evidence. The prevalence of stress incontinence and detrusor overactivity increases with age and affects up to 43.1% of women over 40 years old. The etiology of urinary incontinence includes genitourinary (filling/storage disorders, fistulas, congenital abnormalities) and nongenitourinary (functional, environmental, pharmacologic, metabolic). A patient will usually present complaining of involuntary leakage of urine. This typically occurs with exertion or exercise, or with cough, laugh or sneeze. Urine culture and sensitivity should be obtained when the dipstick test indicates possible infection. Treatment should always begin with lifestyle modifications, including limiting fluid intake and caffeine, avoiding cigarettes, and controlling weight. Available pharmacologic therapy for SUI can cause significant side effects, as many of these medications were not intended to treat urinary incontinence.