3 Simple Incontinence Questions
These three simple and quick incontinence questions, based on the 3IQ incontinence questionnaire, can be very useful in helping you determine what type of incontinence you may be experiencing.
1. During the last 3 months, have you leaked urine (even a small amount)?
Urinary incontinence can be determined by simply asking someone if they ever experience urine leakage that is unintentional. Yet this ignores the fact that it is possible to experience occasional urinary leakage that may be infrequent enough that it is not bothersome. It may be more helpful to describe urinary incontinence as “the involuntary loss of urine” that poses a “social or hygienic problem”. For many patients with urine leakage, incontinence does represent a severe and bothersome stress that has social, financial and psychological consequences.
2. During what kinds of situations did you leak urine?
Beyond simply determining if urine leakage is bothersome, it is important to determine what type of incontinence you are experiencing. Urine leakage can occur in association with physical activity including coughing, sneezing, laughing, exercise or bending over. This is often referred to as Stress Incontinence. The “stress” refers to the increase in the pressure in your abdomen that results in the leakage.
In other patients, a sense of urgency (a sudden urge to urinate that is difficult to postpone) accompanies urinary leakage. Patients with Urgency Incontinence will often urinate frequently and urgently as well, trying to prevent urinary leakage.
Finally, patients may also experience loss of urine without either any exertion or sense of urgency.
3. During what kinds of situations did you leak urine most often?
While we generally describe urinary incontinence as being either Stress Incontinence or Urgency Incontinence, this does not mean that all patients will have either Urgency Incontinence OR Stress Incontinence. In fact, about 40% of patients (and the number may be much higher) with incontinence will experience both Stress Incontinence AND Urgency Incontinence to some degree. This is usually referred to as Mixed Incontinence.
But for many patients, it is useful to determine if either Stress Incontinence or Urgency Incontinence predominates, even if they experience both types. This allows us to focus on what is the more bothersome form of incontinence. It is not unusual for a patient to see improvement in one type of incontinence, only to realize that they have relatively little bother from the other type and do not need further therapy.
In those patients who do not find a connection between urine leakage and either coughing, sneezing, etc, or urgency, there may be another cause of incontinence (neurologic injury, fistula, etc) that needs to be investigated by a specialist in the field.
With three simple questions, patients can often, reliably, identify they type of incontinence they are experiencing. This is useful in guiding both an evaluation of the urine leakage as well as possible therapies available.
At The Overactive Bladder Clinic a part of UT Erlanger Urology in Chattanooga, Tennessee, we specialize in the evaluation and treatment of all forms of urinary incontinence. For more information, contact us at 423-778-4OAB (4622).
Colin M. Goudelocke, M.D. FPMRS
