Urinary Incontinence (UI)

🔍 When to Suspect

Involuntary leakage of urine: on effort (stress URINARY INCONTINENCE [UI]), with a sudden urge (urge UI), a combination (mixed UI), or constant dribbling (overflow UI)

From the full topic in The Ocean Library: Urinary Incontinence (UI)

🧭 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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