Sphincter weakness (urethral sphincter and/or pelvic floor weakness) If the type of urinary incontinence is still not clear, or if red flags such as hematuria, obstructive symptoms, or recurrent urinary tract infections are present, referral to a urologist or urogynecologist should be considered.Ģ4 to 45 percent in women older than 30 years Other components of the evaluation include laboratory tests and measurement of postvoid residual urine volume. These determinations are made using a patient questionnaire, such as the 3 Incontinence Questions, an assessment of other medical problems that may contribute to incontinence, a discussion of the effect of symptoms on the patient's quality of life, a review of the patient's completed voiding diary, a physical examination, and, if stress incontinence is suspected, a cough stress test. The next step is to determine the type of incontinence (urge, stress, overflow, mixed, or functional) and the urgency with which it should be treated. If no reversible cause is identified, then the incontinence is considered chronic. The basic workup is aimed at identifying possible reversible causes. The initial evaluation occurs in the family physician's office and generally does not require urologic or gynecologic evaluation. Urinary incontinence is common, increases in prevalence with age, and affects quality of life for men and women.
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