Urinary Incontinence

Urinary incontinence is involuntary urine leakage and is a symptom rather than one diagnosis. Ask what happens immediately before the leak. Leakage with coughing, sneezing, lifting, or exertion suggests stress incontinence. Leakage with a sudden, difficult-to-defer urge suggests urgency incontinence. Dribbling with incomplete emptying or bladder distension suggests overflow incontinence. When cognition, mobility, clothing, or the environment prevents timely toileting despite otherwise functional urinary control, the pattern is functional incontinence. Stress and urgency features can coexist as mixed incontinence. The pattern changes the first action. Stress and urgency symptoms usually lead to conservative management, while suspected retention requires an assessment of bladder emptying before bladder training or an urgency medicine is continued. Functional incontinence calls for toileting access and assistance as well as assessment for reversible contributors. Absorbent products protect clothing, dignity, and skin but do not treat the cause. Acute inability to pass urine with painful suprapubic distension or anuria is an emergency. Notify the prescriber or most responsible clinician immediately and initiate the local urgent-retention protocol; if timely assessment and bladder drainage are unavailable or the person is...