Classification

NICE, in their guidance in this area, define urinary incontinence (UI) as either:

• stress UI is involuntary urine leakage on effort or exertion or on sneezing or coughing
• urge UI is involuntary urine leakage accompanied or immediately preceded by urgency (a sudden compelling desire to urinate that is difficult to defer)
• mixed UI is involuntary urine leakage associated with both urgency and exertion, effort, sneezing or coughing

Overactive bladder syndrome (OAB) is defined as urgency that occurs with or without urge UI and usually with frequency and nocturia. OAB that occurs with urge UI is known as 'OAB wet'. OAB that occurs without urge UI is known as 'OAB dry'.

• these combinations of symptoms are suggestive of the urodynamic finding of detrusor overactivity, but can be the result of other forms of urethrovesical dysfunction

Notes:

• urology textbooks may also describe UI in terms of:
  • stress UI
  • urge UI
  • true UI - result of communication between the ureter or bladder and the uterus or vagina.
  • overflow UI - characterised by a continuous dribble of urine or leakage of small amounts on effort

It is important to appreciate that these descriptions are not meant to emphasise symptoms but diagnoses. Stress incontinence, for example, may as a symptom feature in all four types of incontinence.

Reference:

1. NICE (April 2019). Urinary incontinence - The management of urinary incontinence in women