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Abstract
Physiological causes may include age-related changes in smooth muscle, altered nerve transmissions at the spinal and cortical levels, hypersensitivity of ion channels and increased afferent nerve activity. Physicians should routinely screen patients for urinary incontinence (Fig. 1) and, in particular, they may consider checking patients with one or more of the following factors [1]: * Older age * Female sex * High presence/severity of cough or dyspnoea * Lower lung function * Limited social activity or relationships. A trial comparing different rehabilitation methods (bladder training, pelvic floor muscle training, combined pelvic floor rehabilitation) and drug therapy in patients with urge incontinence found significant improvement in all treatment groups at 3 and 12 months [12]. Take home messages * Urinary incontinence is more common in COPD patients than in the general population. * Urinary incontinence in COPD patients is not only related to older age or the leakage of urine from increased abdominal pressure while coughing. * Urinary incontinence as a possible adverse effect of respiratory drugs is largely overlooked. * Attempt to discontinue or replace the respiratory or non-respiratory drugs that are potentially responsible for urinary incontinence. * Management options include urinary rehabilitation programmes, antimuscarinic pharmacotherapy and specialist interventions.