Absorbent products:: Pads and garments, either disposable or reusable, worn to contain urinary incontinence or uncontrolled urine leakage. Absorbent products include shields, guards, undergarment pads, combination pad-pant systems, diaperlike garments, and bed pads.

Algorithm:: A step-by-step method for solving a problem. In health care decisionmaking, an algorithm is a defined and prescribed sequential process whereby clinical and diagnostic findings at a particular point in the process determine the next diagnostic, clinical, or therapeutic decision or action to be made or taken.

Anti-incontinence surgery:: The use of surgical procedures to treat urinary incontinence (see artificial urinary sphincter, bladder suspension, periurethral bulking injections, sling procedures).

Artificial urinary sphincter:: A mechanical device surgically implanted into the patient that consists of a cuff, placed around the bulbar urethra or bladder neck, a pressure-regulating balloon, and a pump. The device is used to control opening and closing of the urethra manually and is the most commonly used surgical procedure for the treatment of male urethral insufficiency.

Behavioral techniques:: Specific interventions designed to alter the relationship between the patient's symptoms and his/her behavior and/or environment for the treatment of maladaptive urinary voiding patterns. This may be achieved by modification of the behavior and/or environment of the patient (see biofeedback, bladder training, electrical stimulation, habit training, pelvic muscle exercises, prompted voiding).

Benign prostatic hyperplasia (BPH):: A common disorder of men over the age of 50 characterized by enlargement of the prostate which may press against the urethra and obstruct the flow of urine. BPH is the most common cause of such anatomic obstruction in elderly men.

Biofeedback:: A behavioral technique by which information about a normally unconscious physiologic process is presented to the patient and the clinician as a visual, auditory, or tactile signal. The signal is derived from a measurable physiologic parameter which is subsequently used in an educational process to accomplish a specific therapeutic result. The signal is displayed in a quantitative way, and the patient is taught how to alter it and thus control the physiologic process.

Bladder suspension:: Also called bladder neck suspension. A term for several surgical procedures employed to treat urethral hypermobility by elevating and securing the bladder to its proper position within the body. The two major types of bladder suspension surgical procedures are:

Retropubic suspension:: Consists of several different surgical techniques performed through a low abdominal incision. All techniques are designed to elevate the lower urinary tract within the retropubic space, differing only in the structures used to achieve the elevation.

Needle bladder neck suspension:: Consists of several different surgical techniques performed through a vaginal approach and small low abdominal incision; all involve the use of a long needle to transfer the sutures adjacent to the urethra and bladder neck through the retropubic space into the abdominal wall anterior to the rectus fascia where the sutures are fastened or anchored.

Bladder training:: A behavioral technique that requires the patient to resist or inhibit the sensation of urgency (the strong desire to urinate), to postpone voiding, and to urinate according to a timetable rather than to the urge to void.

Catheterization:: Techniques for managing urinary incontinence that involve the use of a slender tube inserted through the urethra or through the anterior abdominal wall into the bladder, urinary reservoir, or urinary conduit to allow urine drainage (see indwelling catheters, intermittent catheterization).

Clinical practice guidelines:: A set of systematically developed statements or recommendations designed to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Such guidelines are designed to assist health care practitioners in the prevention, diagnosis, treatment, and management of specific clinical conditions.

Condom catheters:: A condomlike device placed over the penis to allow bladder drainage and collection of urine (see external (condom) catheters).

Cystometry:: A test used to assess the function of the bladder by measuring the pressure/volume relationship of the bladder. Cystometry is used to assess detrusor activity, sensation, capacity, and compliance. There are different variations of the test depending on the problem being investigated, but regardless of the technique, cystometry involves insertion of a catheter into the bladder.

Cystourethrography:: The use of x-ray imaging to examine the urinary bladder and urethra. In voiding cystourethrography, an x-ray picture of the bladder and urethra is obtained during urination.

Cystoscopy:: Also called cystourethroscopy. A procedure used to diagnose urinary tract disorders and provide a direct view of the urethra and bladder by inserting a flexible scope into the urethra and then into the bladder.

Decreased bladder compliance:: A failure to store urine in the bladder caused by the loss of bladder wall elasticity and of bladder accommodation. This condition may result from radiation cystitis or from inflammatory bladder conditions such as chemical cystitis, interstitial cystitis, and certain neurologic bladder disorders.

Detrusor:: General term for any part of the body that pushes down. In the urinary system, the detrusor muscle is the smooth muscle in the wall of the urinary bladder that contracts the bladder and expels the urine.

Detrusor sphincter dyssynergia (DSD):: An inappropriate contraction of the external sphincter concurrent with an involuntary contraction of the detrusor. In the adult, DSD is a common feature of neurologic voiding disorders.

Detrusor hyperactivity with impaired bladder contractility (DHIC):: A condition characterized by involuntary detrusor contractions in which patients either are unable to empty their bladder completely or can empty their bladder completely only with straining due to poor contractility of the detrusor.

Detrusor instability (unstable bladder):: Involuntary detrusor contraction in the absence of associated neurologic disorders (see urge incontinence).

Electrical stimulation:: The application of electric current to stimulate or inhibit the pelvic viscera or their nerve supply in order to induce a direct therapeutic response.

Electromyography (EMG):: The study of electrical potentials generated by the depolarization of muscle. EMG of the striated urethral sphincter measures the integrity and function of its nerves and is used to evaluate the neurophysiologic status of the urinary tract during filling and voiding.

External (condom) catheters:: Devices for externally draining the bladder made from latex rubber, polyvinyl, or silicone that are secured on the shaft of the penis by some form of adhesive and are connected to urine collecting bags by a tube.

Habit training:: A behavioral technique that calls for scheduled toileting at regular intervals on a planned basis. Unlike bladder training, there is no systematic effort to motivate the patient to delay voiding and resist urge.

Hydronephrosis:: Dilation of the renal pelvis and calices, and sometimes, collecting ducts, secondary to obstruction of urine flow by calculi, tumors, neurologic disorders, or any various congenital anomalies.

Hypermobility of bladder neck:: A condition characterized by the descent and displacement of the urethra and bladder neck from their normal anatomic position during physical exertion, usually resulting in leakage of urine. This condition is the most common cause of stress urinary incontinence. Various surgical procedures can be employed to treat this condition (see bladder suspension).

Hyperreflexia:: Any exaggeration of reflexes. In urinary incontinence, an involuntary detrusor contraction resulting from a neurologic disorder.

Indwelling catheters:: Tube devices inserted into the bladder, urinary reservoir, or urinary conduit for a period of time longer than one emptying.

Intermittent catheterization:: The use of catheters inserted through the urethra into the bladder every 3-6 hours for bladder drainage in persons with urinary retention.

Intrinsic sphincter deficiency (ISD):: A cause of stress urinary incontinence in which the urethral sphincter is unable to contract and generate sufficient resistance in the bladder, especially during stress maneuvers. ISD may be due to congenital sphincter weakness, such as myelomeningocele or epispadias, or it may be acquired subsequent to prostatectomy, trauma, radiation therapy, or sacral cord lesions.

Involuntary detrusor contraction:: A cause of urinary incontinence resulting from uncontrolled contractions of the detrusor.

Mixed urinary incontinence:: The combination, in a patient, of urge urinary incontinence and stress urinary incontinence (see urge incontinence, stress incontinence).

Nocturnal enuresis:: The involuntary loss of urine (urinary incontinence) during sleep. Also called bed-wetting.

Overactive bladder:: A condition characterized by involuntary detrusor contractions during the bladder filling phase, which may be spontaneous or provoked and which the patient cannot suppress.

Overflow incontinence:: The involuntary loss of urine associated with overdistension of the bladder. Overflow incontinence results from urinary retention that causes the capacity of the bladder to be overwhelmed. Continuous or intermittent leakage of a small amount of urine results.

Pelvic muscle exercises (PMEs):: A behavioral technique that requires repetitive active exercise of the pubococcygeus muscle to improve urethral resistance and urinary control by strengthening the periurethral and pelvic muscles. Also called Kegel exercises or pelvic floor exercises.

Periurethral bulking injections:: A surgical treatment for urethral sphincter insufficiency that involves injecting materials such as polytetrafluoroethylene (PTFE) or collagen into the periurethral area to increase urethral compression.

Pessaries:: Devices for women that are placed intravaginally to treat pelvic relaxation or prolapse of pelvic organs.

Pharmacologic treatment:: The use of medications to treat urinary incontinence.

Post-void residual (PVR) volume:: The amount of fluid remaining in the bladder immediately following the completion of urination. Estimation of PVR volume can be made by abdominal palpation and percussion or bimanual examination. Specific measurement of PVR volume can be accomplished by catheterization, pelvic ultrasound, radiography, or radioisotope studies.

Prompted voiding:: A behavioral technique for use primarily with dependent or cognitively impaired persons. Prompted voiding attempts to teach the incontinent person awareness of his/her incontinence status and to request toileting assistance, either independently or after being prompted by a caregiver.

Sensory urgency:: Urgency associated with bladder hypersensitivity (see urge/urgency).

Sling procedures:: Surgical methods for treating urinary incontinence involving the placement of a sling, made either of tissue obtained from the person undergoing the sling procedure or of tissue obtained from another source, under the urethrovesical junction and anchored to retropubic and/or abdominal structures.

Stress urinary incontinence:: A form of urinary incontinence characterized by the involuntary loss of urine from the urethra during physical exertion; for example, during coughing. The stress incontinence symptom or complaint may be confirmed by observing urine loss coincident with an increase in abdominal pressure in the absence of a detrusor contraction or an overdistended bladder (see hypermobility of bladder neck and intrinsic sphincter deficiency).

Suprapubic cystostomy:: A surgical procedure involving insertion of a tube or similar instrument through the anterior abdominal wall above the symphysis pubis into the bladder to permit urine drainage from the bladder.

Transient urinary incontinence:: Temporary episodes of urinary incontinence that are reversible once the cause or causes of the episode(s) are identified and treated.

Ultrasonography:: A technique that uses ultrasound to obtain visual images of the urinary tract for the purpose of assessing its anatomic status.

Underactive bladder:: A condition characterized by a bladder contraction of inadequate magnitude and/or duration to effect bladder emptying in a normal timespan. This condition can be caused by drugs, fecal impaction, and neurologic conditions such as diabetic neuropathy or low spinal cord injury or as a result of radical pelvic surgery. It also can result from a weakening of the detrusor muscle from vitamin B12 deficiency or idiopathic causes. Bladder underactivity may cause overdistension of the bladder, resulting in overflow incontinence (see overflow incontinence).

Urethral pressure profilometry (UPP):: A technique used to measure resting and dynamic pressures in the urethra.

Urethral sphincter mechanism:: The segment of the urethra that influences storage and emptying of urine in the bladder. It controls bladder voiding by relaxing, which opens the outlet from the bladder, allowing urine to flow from the bladder to the outside of the body. A deficiency of the urethral sphincter mechanism may allow leakage of urine in the absence of a detrusor contraction.

Urge incontinence:: The involuntary loss of urine associated with an abrupt and strong desire to void (urgency). Urge incontinence is usually associated with the urodynamic findings of involuntary detrusor contractions or detrusor overactivity (see detrusor external sphincter dyssynergia, detrusor hyperactivity with impaired bladder contractility, detrusor instability, hyperreflexia, sensory urgency).

Urge/urgency:: A strong desire to void.

Urinary incontinence (UI):: Involuntary loss of urine sufficient to be a problem. There are several types of UI, but all are characterized by an inability to restrain or control urinary voiding (see mixed urinary incontinence, nocturnal enuresis, overflow incontinence, stress incontinence, transient urinary incontinence, urge incontinence).

Urinary tract:: Passageway from the pelvis of the kidney to the urinary orifice through the ureters, bladder, and urethra.

Urinary tract infection (UTI):: An infection in the urinary tract caused by the invasion of disease-causing micro-organisms, which proceed to establish themselves, multiply, and produce various symptoms in their host. Infection of the bladder, better known as cystitis, is particularly common in women, mainly because of the much shorter urethra, which provides less of a barrier to bacteria. In men, infection is usually associated with obstruction to the flow of urine, such as prostate gland enlargement.

Urodynamic tests:: Tests designed to determine the anatomic and functional status of the urinary bladder and urethra (see cystometry, electromyography, urethral pressure profilometry, uroflowmetry, videourodynamics).

Uroflowmetry:: A urodynamic test that measures urine flow either visually, electronically, or with the use of a disposable flowmeter unit.

Vesicoureteric reflux:: Backflow of urine from the bladder into the ureter, unilaterally or bilaterally, during rest or especially during urination. The condition may be congenital, secondary to obstruction of the urinary outflow tract, or any disease involving the urinary ureteral orifices.

Videourodynamics:: A technique that combines the various urodynamic tests with simultaneous fluoroscopy. Fluoroscopy is a technique for examining internal structures by viewing the shadows cast on a fluorescent screen by objects or parts through which x-rays are directed.

Voiding or bladder diary (record):: Also called an "incontinence chart." A record maintained by the patient or caregiver that is used to record the frequency, timing, amount of voiding, and/or other factors associated with the patient's urinary incontinence.