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Urinary Incontinence

Reversible Causes

Eliminate reversible causes.

Causes/contributing factors Recommendations or explanations
Delirium Identify cause(s): metabolic, infectious, neurological
Infection Treat the infection
Atrophic vaginitis Treat with topical estrogen
Medications

Consider stopping or substituting the following medications if possible:

  • anticholinergics
  • antidepressants
  • antipsychotics
  • hypnotics/sedatives
  • antihistamines
  • narcotics
  • alpha-adrenergic agonists
  • diuretics
  • angiotensin conversion enzymes (if they cause coughing)
Psychological Severe depression (rare)
Excess urination Heart failure, diabetes, peripheral edema, use of diuretics, excess liquid consumption
Reduced mobility Use of a commode, prescribe a walker, send to physio to improve gait speed and joint function
Constipation Treat appropriately
Neurological lesions Eliminate the possibility of tumours on the discs, brain and spinal cord, as well as cervical lesions, and treat.
Bladder pathology Hematuria may indicate bladder stones, polyps, tumors, or inflammations. Diagnostic, cystoscopy required.
Hypercalcemia Correct and look for underlying pathology as it may cause excessive urination.
Weakness of pelvic floor muscles Causes urine leakage on the way to the bathroom. Treat with pelvic floor muscles exercises.
Alcohol Limit or eliminate alcohol consumption
Caffeine Limit or eliminate caffeine consumption (coffee, tea, chocolate)
Excessive ingestion of liquids Limit liquid consumption
Dementia Dementia as such does not cause urinary incontinence, but the related functional deficits (such as undressing apraxia or mobility problems, for example) may lead to incontinence.
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