Urinary incontinence underactivity

Vaginally-administered estrogen plays only a modest role in managing stress urinary incontinence (urethral underactivity), unless it is accompanied by local signs of estrogen deficiency (e.g., atrophic urethritis or vaginitis). 

Overflow Urinary Incontinence (OUI) (Urethral Overactivity and/or Bladder Underactivity)4... 

This type of UI is known as stress urinary incontinence (SUI). Although the exact etiology of urethral underactivity and SUI in the woman is incompletely understood, clearly identifiable risk factors include pregnancy, childbirth, menopause, cognitive impairment, obesity, and age. The prevalence of SUI in women appears to peak during or after the onset of menopause. This implies that hormonal factors are important in maintaining continence. 

CLINICAL PRESENTATION OF URINARY INCONTINENCE RELATED TO URETHRAL UNDERACTIVITY... 

Urinary incontinence—Involuntary leakage of urine. May result from urethral underactivity (stress urinary incontinence), urethral overactivity (overflow incontinence), or mixed pathophysiologic mechanisms. 

Duloxetine (when approved for treatment of urinary in- continence), a-adrenergic receptor agonists, and topical (vaginal) estrogens (alone or together) are the therapies of choice in urethral underactivity (stress incontinence). 

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