Urinary incontinence

Abstract

According to the most recent definition of the International Continence Society, urinary incontinence (UI), a symptom of impaired storage, is ‘the complaint of any involuntary leakage of urine’. A condition that primarily affects women, UI is not a lethal condition; however, it significantly affects quality of life. Three types of incontinence are generally distinguished: stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence, which associates with the first two. Prevalence varies significantly due to variations in definitions and measurement, methodology of data collection, lack of self-reporting, and sampling/non-response issues. Age, parity, vaginal childbirth, and body mass index are important factors that affect the prevalence of urinary incontinence. In 2005, the ‘Evaluation of the Prevalence of urinary InContinence’ (EPIC) study, which was the largest population-based survey of 19,165 individuals, was conducted in five developed countries to assess the prevalence of lower urinary tract symptoms in men and women. Prevalence of overactive bladder overall was 11.8%; rates were similar in men and women and increased with age. Overactive bladder was more prevalent than all types of UI combined (9.4%). Besides the obvious issue of hygiene, UI results in ramifications that extend to the sufferer’s social and sexual life. This chapter focuses on mainly three types of female urinary incontinence commonly encountered in clinical practice—stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence—and discusses the anatomy and physiology of the continence apparatus, and the classification, evaluation, and management of urinary incontinence.