386 Obstetrics and Gynecology Board Review •••
❍ What is genuine stress urinary incontinence (GSUI)?
The involuntary loss of urine secondary to increases in intra-abdominal pressure (coughing or bearing down)
without a bladder contraction or when leakage of urine occurs when intra-abdominal pressure exceeds urethral
closure pressure, with no bladder contraction.
❍ What is detrusor overactivity incontinence?
Detrusor overactivity is also known as overactive bladder (OAB) or urge incontinence. It is the involuntary loss
of urine following a strong urge to void. Detrusor overactivity associated with the urge to void without associated
incontinence is also called “dry” urge incontinence.
❍ What is urge urinary incontinence?
It is the involuntary loss of urine following a strong urge to void. Detrusor overactivity is also known as OAB.
❍ What is mixed urinary incontinence?
Urinary urge incontinence (UUI) and GSUI occurring together in the same patient.
❍ What is overflow incontinence?
The involuntary loss of urine secondary to bladder over distension. The hydrostatic pressure within the bladder
rises above the urethral pressure and a “decompression” of pressure occurs often leaving a high-volume residual as
there is no detrusor contraction.
❍ What are some causes of overflow incontinence?
Bladder atony (postepidural, diabetic neuropathy)
Outflow obstruction (pelvic mass, pelvic organ prolapse, gravid uterus with extreme retroversion)
❍ What type of incontinence is associated with urinary retention?
Overflow incontinence.
❍ What are three rare causes of urinary incontinence?
Ectopic ureter
Fistulas
Urethral diverticulum
❍ What should always be ruled out when a patient presents with complaints of incontinence?
Reversible causes of incontinence.
❍ What are the reversible causes of incontinence?
Remember the mnemonic “DIAPPERS”:
Delirium
Infection (lower urinary tract)
Atrophic vaginitis
Psychological (depression, dementia)
Pharmaceutical (including alcohol, caffeine)