Urinary Incontinence For Health Professionals: Reversible Causes

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)
• oral estrogens

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.