Urinary Incontinence

Urinary incontinence is a symptom, not a single diagnosis. The bedside question that narrows the problem fastest is what happens immediately before the urine escapes: exertion, a sudden urge, incomplete emptying, or an inability to reach the toilet. Those patterns point toward stress, urgency, overflow, or functional incontinence, respectively; mixed patterns can occur. This distinction changes the plan. Pelvic-floor muscle training and bladder training address common mechanisms, but a patient with retention needs assessment of bladder emptying, and a patient who cannot reach the toilet needs mobility and environmental support. Medication is not a substitute for identifying the pattern. New hematuria, acute retention, worsening renal function, recurrent infection, or unexplained suprapubic pain changes the priority from routine continence management to urgent clinical review. The anatomy and bladder-control pathways behind these patterns make the assessment findings more predictable.