Urge UI (UUI): In UUI, urine leakage is due to involuntary contractions of the bladder. Certain medications, such as alpha-antagonists and ACE inhibitors, can exacerbate existing SUI. SUI occurs more often in females than in males and is associated with pregnancy, childbirth, menopause, and obesity. Activities such as exercise, coughing, sneezing, and lifting frequently trigger it. Stress UI (SUI): SUI involves an involuntary loss of urine caused by inadequate urethral-sphincter closure under increased intra-abdominal pressure. There are multiple classifications of UI, including stress, urge, overflow, functional, and mixed UI. UI occurs when there are abnormalities in the function of the bladder, the sphincters, or both. With normal voiding, the urinary sphincters relax and the bladder muscles contract simultaneously, enabling appropriate urine flow. The central nervous system also prevents smooth-muscle activity in the bladder as it fills. 1 The unique structure of the bladder allows for an increase in urine volume without significant increases in bladder pressure. In normal urinary function, the sphincters remain closed, causing the urine to remain in the bladder until a person voluntarily urinates. 1 If a patient does not seek treatment for UI symptoms, there can be potential medical consequences, such as urinary tract infections, perineal irritation, and worsening pressure ulcers. 2 Over time, the individual may feel a loss of control, a loss of independence, or poor self-esteem, which can result in psychological conditions such as depression. 1 The condition may cause patients to feel uncomfortable in social situations and to avoid certain activities. UI significantly and negatively impacts one’s quality of life. The overall estimated prevalence in men is much lower (3% to 11%). 1 It is difficult to determine the exact prevalence of this condition however, it is estimated that UI affects 20% to 30% of young females, 30% to 40% of middle-aged females, and 30% to 50% of elderly females. Although UI seems to occur most frequently in women of menopausal age, anyone can be affected. 1,2 Symptoms of UI include urgency (a sudden need to urinate that is difficult to suppress), increased daytime frequency (urination >8 times per day), and nighttime urination. Urinary incontinence (UI), which is defined as an involuntary leakage of urine, is a common problem in the United States. Many of the pharmacologic options for UI are associated with undesirable, yet manageable, adverse effects therefore, counseling is important in fostering patient adherence to medications used to treat UI. When nonpharmacologic measures are insufficient, pharmacologic options may be considered for some types of UI. First-line treatment involves nonpharmacologic measures regardless of UI type. UI may be classified as stress, urge, overflow, functional, or mixed, depending on the underlying etiology. UI involves involuntary urine leakage, which can result in a number of symptoms, including urgency, frequency, and nocturia. ABSTRACT: Urinary incontinence (UI) is a common problem, especially in women, and it can significantly impact quality of life.
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