Causes of Urinary Incontinence - Differential Diagnosis Algorithm
- Transient - Easily reversible cause (DIAPPERS)
• Delirium/confusional states
• Infection (UTI)
• Atrophic urethritis/vaginitis
• Pharmaceuticals
• Psychological/psychiatric
• Excessive urine output
• Restricted mobility
• Stool impaction
- Stress Incontinence - Failure of urethral sphincter to remain closed - Small Volume, Precipitated by stress maneuvers, More common in multiparous women
- Urge Incontinence - Detrusor overactivity, Abrupt urgency, Moderate to large leakage of urine, Precipitated by cold temperature & running water
- Overflow Incontinence - Distended bladder with high post-void residual volume, Continuous small volume leakage +/- Precipitated by stress maneuvers
• Impaired Detrusor Contraction - Signs of autonomic neuropathy or spinal cord disease, cauda equina syndrome, anticholinergic medications
• Bladder Outlet Obstruction
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