It is defined as involuntarily leakage of urine. It may occur in patients with a normal urinary tract, as the result of dementia or poor mobility or transiently during acute illness or hospitalization, especially in older people.


  • Female more than male
  • Child birth
  • Hysterectomy
  • Obesity
  • Recurrent UTI
  • Smoking
  • Caffeine
  • Spinal injury
  • Constipation
  • Idiopathic
  • Atony of urinary bladder


  • Patient should be encouraged to keep a voiding diary, including the measured volume voided, frequency of voiding, a note of incontinence pad usage, precipitating factors and associated feature such as urgency, since this can be diagnostic value.
  • The patient should be assessed for evidence of cognitive impairment and impaired mobility.
  • A neurological assessment should be performed to detect disorders such as multiple sclerosis that may affect the nervous supply of the bladder.
  • Lumbar spine should be inspected for features of spinal bifida occulta.
  • Perineal sensation and anal sphincter tone should be assessed.
  • Rectal examination need to assess for prostate in men and exclude faecal impaction as a cause
  • Genital assessment should be performed to identify phimosis or paraphimosis in men and vaginal mucosal atrophy, cystocels or rectoceles in women.


  • Urinalysis and culture in all patient.
  • USG will help for flow and incomplete bladder emptying.
  • Cystometrography
  • CT scan and cystoscopy should be perform in suspecting of fistula.
  • MRI in urethral diverticulum suspecting.