- Published on
Symptoms and Signs – Differential Diagnosis of Urinary incontinence
Stress incontinence
Females: pelvic floor weakness/bladder neck descent (pregnancy, vaginal
delivery, obesity, menopause)
Males: prostate surgery (external urethral sphincter damage)
Urge incontinence
Detrusor instability (idiopathic, secondary to bladder outflow obstruction, loss of supra-spinal inhibition with UMN lesions, e.g. CVA, MS, cord compression: disc lesions/spinal tumours, spinal cord/head injury)
Bladder stone, tumour, infection (cystitis)
Continuous incontinence
Chronic retention/overdistension/overflow:
Outflow obstruction (see urinary retention)
Bladder atonia due to damage to 52, 53, 54 parasympathetic fibres in lower
spinal cord, caucfa equina or pelvis, diabetic autonomic neuropathy Fistula (e.g. vesicovaginal) secondary to obstructed labour, surgery,
malignancy, radiotherapy
Note: Detrusor instability and chronic retention/overdistension of bladder can
also cause stress incontinence.
Stress incontinence
Females: pelvic floor weakness/bladder neck descent (pregnancy, vaginal
delivery, obesity, menopause)
Males: prostate surgery (external urethral sphincter damage)
Urge incontinence
Detrusor instability (idiopathic, secondary to bladder outflow obstruction, loss of supra-spinal inhibition with UMN lesions, e.g. CVA, MS, cord compression: disc lesions/spinal tumours, spinal cord/head injury)
Bladder stone, tumour, infection (cystitis)
Continuous incontinence
Chronic retention/overdistension/overflow:
Outflow obstruction (see urinary retention)
Bladder atonia due to damage to 52, 53, 54 parasympathetic fibres in lower
spinal cord, caucfa equina or pelvis, diabetic autonomic neuropathy Fistula (e.g. vesicovaginal) secondary to obstructed labour, surgery,
malignancy, radiotherapy
Note: Detrusor instability and chronic retention/overdistension of bladder can
also cause stress incontinence.
0 Comments
