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Published online: 29 April 2020
© Springer Nature Switzerland AG 2020
Abstract
Urinary incontinence is a seemingly common, but largely unexplored, comorbidity associated with chronic obstructive pulmonary disease (COPD). It is not only related to older age or the leakage of urine from increased abdominal pressure while coughing (i.e. stress incontinence), but is also possibly an adverse effect of respiratory or non-respiratory drugs. Physicians should actively and routinely screen COPD patients for urinary incontinence and choose the course of management depending on whether it is stress, urge or mixed. Management options include discontinuing or replacing offending agents, prompt referral to specialist continence therapists and antimuscarinic pharmacotherapy.
Common but largely unexplored
Urinary incontinence is a seemingly common, yet largely unexplored, comorbidity associated with chronic obstructive pulmonary disease (COPD) [1]. Misinterpreting urinary symptoms as being related to the respiratory condition can delay the diagnostic approach and management of urinary incontinence, leading to a considerable impact on healthrelated quality of life (HR-QoL) [1]. This article provides an overview of the assessment and management of urinary incontinence in patients with COPD, as reviewed by Battaglia et al. [1].
Understand the background
COPD is a progressive lung disease that is characterized by breathlessness, chronic cough and sputum production [2]. The typical COPD patient is an older individual with comorbidities and consequent polypharmacy [1]. Urinary incontinence is reportedly one of several comorbidities that have the most impact on self-rated health in COPD patients [3]. Urinary incontinence, defined as the complaint of any involuntary leakage of urine, is divided into three main categories [4]:
* Stress incontinence Involuntary leakage on effort or exertion (e.g. coughing or sneezing).
* Urge incontinence Involuntary leakage accompanied by, or immediately preceded by, urgency (i.e. a sudden compelling desire to void that is difficult to defer).
* Mixed incontinence Involuntary leakage associated with effort or exertion, as well as with urgency.
Symptoms of urinary incontinence can range from mild leaking to uncontrollable wetting [1]. Although urinary incontinence can occur at any age, it becomes more common with increasing age [1].
The prevalence of urinary incontinence in COPD patients is mostly unexplored in clinical research and underestimated in clinical practice [1]. However, evidence suggests that the prevalence of urinary incontinence is higher in individuals with COPD than...