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Patient handout

Urinary Incontinence — chronic outpatient evaluation (stress / urge / mixed / overflow / functional / continuous / pediatric / post-prostatectomy)

PRODUCTION

1. Your condition

This handout is for urinary incontinence — chronic outpatient evaluation (stress / urge / mixed / overflow / functional / continuous / pediatric / post-prostatectomy). Your care team identified this based on: involuntary urine loss with cough / sneeze / exertion — stress ui (aua oab 2019; nice ui 2019).

Other reasons your team may use this plan: urgency leakage / detrusor overactivity — urge ui / oab (aua oab 2019); combined stress + urge components — mixed ui (nice ui 2019); continuous dribbling + incomplete emptying — overflow ui; route to uro.bph.v1 if bph overlay.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
Behavioral therapy — bladder training, timed voiding, urge suppression, fluid timing———AUA OAB 2019 / NICE UI 2019 first-line for all phenotypes (PMID 31039103;)
Lifestyle modification — caffeine / alcohol / artificial sweetener reduction, weight loss if BMI >25, smoking cessation, bowel regimen———AUA OAB 2019 / NICE UI 2019

Plan: Urge UI / OAB — AUA 2019 ladder: behavioral → antimuscarinic OR β3 → botox → SNM / PTNS

3. When to call your provider

Contact your care team if any of the following happen:

  • Hematuria → AUA 2020 microhematuria workup → STAT urology + cystoscopy (AUA microhematuria 2020)
  • Recurrent UTI → uro.uti.complicated.v1 workup (CDC STI 2021)
  • Saddle anesthesia / lower extremity weakness → STAT neuro / spine imaging (cauda equina) (AUA OAB 2019)
  • AUR with palpable bladder → STAT ED for Foley + uro.bph.v1 workup (AUA BPH 2021)
  • Refractory to ≥3 ladder steps → uro / urogyn surgical evaluation (NICE UI 2019)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • Continuous UI — fistula (vesicovaginal / ureterovaginal) post-obstetric / post-surgical / post-radiation (NICE UI 2019)

5. Follow-up

Annual re-evaluation; treatment de-escalation if stable; deprescribing review for anticholinergic burden in elderly; pediatric enuresis transition off therapy (AUA OAB 2019; AGS Beers)

6. Sources

Guideline: AUA OAB 2019 + NICE UI in women 2019 + AGS Beers (anticholinergic burden) + post-RP UI sling + AUA pediatric enuresis + Resnick DIAPPERS

  1. pubmed.ncbi.nlm.nih.gov/31039103