Editing AUA: Incontinence after Prostate Therapy (2019) (section)

== Diagnosis and Evaluation ==

=== UrologySchool.com Summary ===
*'''<span style="color:#ff0000">Recommended</span>'''
** '''<span style="color:#ff0000">History and Physical Exam</span>'''
** '''<span style="color:#ff0000">Labs</span>'''
***'''<span style="color:#ff0000">Urinalysis +/- culture</span>'''
**'''<span style="color:#ff0000">Other</span>'''
***'''<span style="color:#ff0000">Appropriate diagnostic modalities to categorize type and severity of incontinence and degree of bother</span>'''
* '''<span style="color:#ff0000">Optional</span>'''
**'''<span style="color:#ff0000">Post-void residual</span>'''

=== Recommended ===
*'''<span style="color:#ff0000">History and Physical Exam</span>'''
** '''<span style="color:#ff0000">History</span>'''
*** '''<span style="color:#ff0000">Characterize incontinence</span>'''
****'''<span style="color:#ff0000">Type of incontinence</span>'''
*****Treatment for SUI (caused by sphincteric insufficiency) vs. urgency incontinence (caused by bladder dysfunction) are different.
****** '''In cases of mixed incontinence, determine which component is more prevalent and bothersome''' (stress or activity related versus urgency related)
******* Increases in abdominal pressure such as that caused by straining, walking, cough, and exercise are suggestive of SUI
******* The sudden compelling desire to void that is difficult to defer and results in leakage indicates urgency incontinence.
******* Presence of incontinence while asleep as well as nocturia are also important to note, because this may indicate urgency urinary incontinence or severe SUI.
****'''Progression or resolution of incontinence over time, exacerbating factors'''
****'''<span style="color:#ff0000">Severity of incontinence</span>''' (i.e. volume lost over time)
*****'''Can be determined by history, or more objectively, by pad testing'''
***** In the case of sphincteric insufficiency, some treatments (e.g., male slings), clearly have inferior results in severe incontinence.
****'''<span style="color:#ff0000">Degree of bother</span>'''
*'''<span style="color:#ff0000">Labs</span>'''
**'''<span style="color:#ff0000">Urinalysis +/- culture</span>'''

=== Optional ===
*'''<span style="color:#ff0000">Post-void residual (PVR)</span>'''
** '''<span style="color:#ff0000">May be helpful to rule out significant retention of urine if overflow incontinence is suspected.</span>'''
*** Elevated PVR may be an indication of detrusor underactivity or obstruction and thus may prompt further diagnostic evaluation