What is the focus of clinical history for the evaluation of urinary incontinence?

Updated: Jan 22, 2021
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

The following points regarding the clinical presentation should be sought when obtaining the history:

  • Severity and quantity of urine lost and frequency of incontinence episodes
  • Duration of the complaint and whether problems have been worsening
  • Triggering factors or events (eg, cough, sneeze, lifting, bending, feeling of urgency, sound of running water, sexual activity/orgasm)
  • Constant versus intermittent urine loss
  • Associated frequency, urgency, dysuria, pain with a full bladder
  • History of urinary tract infections (UTIs)
  • Concomitant fecal incontinence or pelvic organ prolapse
  • Coexistent complicating or exacerbating medical problems
  • Obstetrical history, including difficult deliveries, grand multiparity, forceps use, obstetrical lacerations, and large babies
  • History of pelvic surgery, especially prior incontinence procedures, hysterectomy, or pelvic floor reconstructive procedures
  • Other urologic procedures
  • Spinal and central nervous system surgery
  • Lifestyle issues, such as smoking, alcohol or caffeine abuse, and occupational and recreational factors causing severe or repetitive increases in intra-abdominal pressure
  • Medications

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