The evaluation of nonneurogenic urinary incontinence in the transitional urologic population requires a thorough history and exam, review of prior workup and therapies, and discussion of patient preferences and treatment goals. This chapter reviews urgency urinary incontinence (UUI) and stress urinary incontinence (SUI), in addition to nocturnal enuresis. Shared decision-making is recommended when discussing treatment options for UUI, which include behavioral therapies, pharmacologic agents (anticholinergics, beta-3 agonists), and minimally invasive treatments such as sacral neuromodulation (SNM), botulinum toxin, and tibial nerve stimulation. Treatment options for SUI include observation, pelvic floor therapy, continence vaginal inserts, and surgical procedures, including bulking agents, urethral suspensions, and sling procedures. Again, the urologist should use shared decision-making, particularly considering plans for childbearing. Finally, nocturnal enuresis in the transitional urologic patient warrants evaluation for behavioral, medical, and lifestyle-related factors. This chapter focuses on important aspects of the workup, treatment options, and counseling considerations for these conditions.

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Urinary Incontinence

  • Julia Drexelius,
  • Meredith C. Wasserman

摘要

The evaluation of nonneurogenic urinary incontinence in the transitional urologic population requires a thorough history and exam, review of prior workup and therapies, and discussion of patient preferences and treatment goals. This chapter reviews urgency urinary incontinence (UUI) and stress urinary incontinence (SUI), in addition to nocturnal enuresis. Shared decision-making is recommended when discussing treatment options for UUI, which include behavioral therapies, pharmacologic agents (anticholinergics, beta-3 agonists), and minimally invasive treatments such as sacral neuromodulation (SNM), botulinum toxin, and tibial nerve stimulation. Treatment options for SUI include observation, pelvic floor therapy, continence vaginal inserts, and surgical procedures, including bulking agents, urethral suspensions, and sling procedures. Again, the urologist should use shared decision-making, particularly considering plans for childbearing. Finally, nocturnal enuresis in the transitional urologic patient warrants evaluation for behavioral, medical, and lifestyle-related factors. This chapter focuses on important aspects of the workup, treatment options, and counseling considerations for these conditions.