GPAtlas🧭 When to suspect
Suspect urinary incontinence (UI) in any patient reporting the involuntary leakage of urine.
First, classify the type from the history: the entire management pathway diverges from that one decision.
Having classified, two pieces of groundwork are mandatory before any treatment:
• A urine dipstick in everyone.
• A bladder diary.
NICE NG123 covers the assessment and management of UI in women, and most evidence-based primary-care UI pathways are built on it.
Men whose dominant picture is lower urinary tract symptoms (hesitancy, weak stream, terminal dribbling) are assessed under the separate LUTS-in-men pathway, but the same red-flag and cancer-referral principles apply throughout.
| Type | Typical history |
|---|---|
| Stress UI | Leakage on effort or exertion – coughing, sneezing, laughing, lifting, exercise. |
| Urgency UI or overactive bladder (OAB) | • Sudden compelling urge to void, with leakage before reaching the toilet • Often frequency and nocturia |
| Mixed UI | Features of both stress and urgency. |
| Overflow UI | Continuous dribbling, hesitancy, poor stream, sense of incomplete emptying (obstruction or underactive detrusor). |
Source: NICE NG123
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