Table 1Definitions of urinary incontinence (UI) and treatment outcomes9

OutcomeDefinition
Symptoms of UI141Complaint of involuntary loss of urine
Signs of UIObservation of involuntary loss of urine on examination; may be urethral or extraurethral
Transient UI142,143Potentially reversible incontinence resulting from conditions that may resolve if the underlying cause is managed: delirium/confusional state; urinary tract infection (symptomatic); atrophic urethritis/vaginitis; use of pharmaceuticals; psychological conditions, especially depression; excessive urine output related to another medical condition (e.g., congestive heart failure, hyperglycemia); restricted mobility; stool impaction
Established UI142,143UI that is attributed to bladder or urethral dysfunction, such as detrusor overactivity, detrusor underactivity, urethral obstruction, urethral incompetence
Stress UIComplaint of involuntary loss of urine on effort or physical exertion (or on sneezing or coughing)
Pure (urodynamic) stress UIThe finding of involuntary leakage during filling cystometry, associated with increased intra-abdominal pressure (stress test), in the absence of a detrusor contraction
Urgency UI10Complaint of involuntary loss of urine associated with urgency
Pure (urodynamic) detrusor overactivityObservation of involuntary leakage from the urethra synchronous with the sensation of a sudden compelling desire to void that is difficult to defer; involuntary detrusor muscle contractions occur during filling cystometry
Overactive bladder144Urinary urgency, usually accompanied by frequency and nocturia, with or without urgency UI, in the absence of urinary tract infection or other obvious pathology. Treatment effectiveness is judged based on decreased voiding and urgency frequency and urgency UI
UI associated with poor bladder emptying145UI associated with: bladder over distention; a contractile detrusor; hypotonic or underactive detrusor, occurring secondarily to drugs, fecal impaction, diabetes, lower spinal cord injury, or disruption of the motor innervations of the detrusor muscle
Mixed UI141Complaint of involuntary loss of urine associated with urgency and also with effort or physical exertion or on sneezing or coughing
Predominant stress UIMixed UI with predominant, more frequent symptoms of stress UI
Predominant urgency UIMixed UI with predominant, more frequent symptoms of urgency UI
Postural UIComplaint of involuntary loss of urine associated with change of body position, for example, rising from a seated or lying position
Continuous UIComplaint of continuous involuntary loss of urine
Coital incontinenceComplaint of involuntary loss of urine with coitus; this symptom might be further divided into that occurring with penetration or intromission and that occurring at orgasm
Insensible UIComplaint of UI where the woman has been unaware of how it occurred
Nocturnal enuresisComplaint of involuntary urine loss that occurs during sleep
Acute UI146Sudden onset of symptoms related to an illness, treatment, or medication
Chronic UIPersistent UI, including disorders of storage (stress and urgency) and of emptying (overflow) and functional and mixed incontinence
Severity of UIMeasured as incontinent episodes/unit time, pad changes/unit time, pad weight/unit time, number of micturitions/unit time, urine loss on a pad test; also indicated by urodynamically diagnosed detrusor overactivity, urodynamic stress incontinence
Outcomes to examine treatment effectiveness
ContinenceAbsence of any involuntary leakage of urine
Author’s reports of cure, absence of incontinent episodes in bladder diaries, negative pad stress, or no abnormalities noted on urodynamics
Resolved stress UINo involuntary urine leakage on physical exertion or effort or with sneezing or coughing
Resolved urgency UINo involuntary leakage accompanied by or immediately proceeded by urgency
Resolved mixed UINo involuntary leakage associated with urgency or with exertion, effort, sneezing, or coughing
Improvement in UIReduction in frequency and severity of incontinence episodes by >50%
Reduction in pad stress test by >50%
Reduction in restrictions of daily activities due to incontinence
Women’s perception of improvement in their bladder condition
Treatment failureProgression of incontinence: increase in frequency and severity of incontinence episodes
Increase in restrictions of daily activities because of incontinence
Continence not achieved
No reduction in the frequency and severity of incontinent episodes
Discontinuation of treatmentSubject refusal to continue treatment
Discontinuation of treatment due to adverse effectSubject refusal to continue treatment due to adverse effects or physician decision to withdraw treatment due to adverse effects
Discontinuation of treatment due to treatment failureSubject refusal to continue treatment due to lack of efficacy
Quality of lifeSubject’s reports about emotional, physical, and social wellbeing
Adverse effectsAny harmful and undesired effect in treated subjects

From: Introduction

Cover of Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness
Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness [Internet].
Comparative Effectiveness Reviews, No. 36.
Shamliyan T, Wyman J, Kane RL.

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