Isolated Urinary Incontinence Without Fecal Incontinence

CLINICAL DIAGNOSTIC MANUAL

Isolated urinary incontinence refers to the involuntary leakage of urine without concurrent fecal incontinence. This condition can significantly impact a patient’s quality of life and may arise from various underlying causes, including neurological, structural, or functional abnormalities of the urinary system. A detailed history, physical examination, and appropriate diagnostic testing are essential to identify the specific cause of urinary incontinence and to guide effective treatment.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmatory Diagnosis
Stress Urinary Incontinence	Involuntary leakage of urine during activities that increase intra-abdominal pressure (e.g., coughing, sneezing, laughing, physical activity)	Clinical history, physical examination	Urodynamic studies, pelvic floor ultrasound
Urge Urinary Incontinence	Sudden, intense urge to urinate followed by involuntary leakage, frequent urination, nocturia	Clinical history, physical examination	Urodynamic studies, bladder diary, cystoscopy
Overflow Incontinence	Dribbling of urine, weak urinary stream, sensation of incomplete emptying, frequent urination, nocturia	Clinical history, physical examination, digital rectal exam (DRE) in men	Post-void residual measurement, bladder ultrasound, urodynamic studies
Neurogenic Bladder	Urinary incontinence, urgency, frequency, possibly associated with neurological symptoms (e.g., spinal cord injury, multiple sclerosis)	Clinical history, neurological examination, physical examination	Urodynamic studies, MRI or CT of the spine, cystoscopy
Post-Prostatectomy Incontinence	Incontinence following prostate surgery, especially after radical prostatectomy, stress-induced leakage	Clinical history, surgical history, physical examination	Urodynamic studies, cystoscopy
Functional Urinary Incontinence	Inability to reach the toilet in time due to physical or cognitive impairments, rather than an underlying urological issue	Clinical history, physical examination	Functional assessment, bladder diary
Urethral Diverticulum	Recurrent urinary tract infections, dribbling, dysuria, dyspareunia, palpable mass near the urethra	Clinical history, physical examination	MRI, urethroscopy, voiding cystourethrography (VCUG)