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Incontinência urinária em mulheres

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 5 Feb 2026
Last updated: 24 Dec 2025

Summary

Definition

History and exam

Key diagnostic factors

  • idade superior a 50 anos
  • IMC acima de 25
  • paridade elevada
  • perda involuntária de urina por esforço, atividade física, espirros ou tosse
  • perda involuntária de urina acompanhada ou imediatamente precedida por urgência
  • aumento da frequência urinária
  • noctúria
  • uso de medicamentos que podem causar incontinência urinária
Full details

Other diagnostic factors

  • diário miccional sugestivo
  • protuberância vaginal/pressão
  • atrofia urogenital
  • prolapso uterino ou fraqueza de suporte posterior
  • permanência prolongada em unidade de cuidados
  • insuficiência cardíaca crônica
  • diabetes mellitus
  • excesso de ingestão de líquidos
  • comprometimento cognitivo ao exame de estado mental
  • história de doença neurológica
  • história de lesão no dorso
  • história de infecções recorrentes do trato urinário
  • disúria
  • hematúria
  • gotejamento após a micção
  • acúmulo de urina no trato vaginal
  • secreção ou sensibilidade uretral
  • útero aumentado
  • perda da sensação do períneo
  • reflexos bulbocavernosos e de piscamento anormais
  • tônus enfraquecido do esfíncter
  • impactação fecal
Full details

Risk factors

  • idade mais avançada
  • gestação
  • obesidade
  • prolapso de órgão pélvico
  • pós-menopausa
  • uso de diuréticos
  • consumo de cafeína
  • constipação
  • incontinência fecal
  • atividade física de alto impacto
  • apneia obstrutiva do sono
  • permanência prolongada em unidade de cuidados
  • demência
  • AVC e outros distúrbios do sistema nervoso central/espinhais
  • Doença de Parkinson
  • esclerose múltipla
  • mulheres brancas
  • comprometimento funcional
  • história familiar de incontinência
  • enurese na infância
  • tosse crônica
  • diabetes mellitus
  • depressão
  • insuficiência cardíaca crônica
  • tabagismo
  • cirurgias geniturinárias e pélvicas
  • exposição à radiação
  • consumo de bebidas alcoólicas
  • uso de anti-histamínicos
  • uso de sedativos
  • uso de hipnóticos
  • uso de analgésicos opioides
  • uso de anticolinérgicos
  • uso de antidepressivos
  • uso de antipsicóticos
  • uso de alfabloqueador
  • uso de bloqueadores dos canais de cálcio
Full details

Diagnostic tests

1st tests to order

  • teste de esforço por tosse
  • urinálise
  • medição do resíduo pós-miccional
  • teste de esforço com a bexiga vazia em posição supina
Full details

Tests to consider

  • teste urodinâmico
  • teste do absorvente (pad test)
  • teste do cotonete (Q-tip test)
  • ultrassonografia transperineal
  • cistouretroscopia
Full details

Treatment algorithm

ONGOING

incontinência urinária de esforço

incontinência de urgência

incontinência mista

Contributors

Authors

G. Willy Davila, MD

Medical Director

Women and Children’s Services

Urogynecology and Pelvic Reconstructive Surgery

Holy Cross Medical Group

Fort Lauderdale

Florida

FL

Disclosures

GWD is a consultant/advisory board member for Boston Scientific and Laborie/Cogentix, and a speaker for Laborie/Cogentix, Astellas, Alma, and Ferring. GWD has received research grants from POP Medical, Pfizer, Cook Biomedical, Alma, and Coloplast.

Laura Martin, DO

Assistant Professor

Female Pelvic Medicine and Reconstructive Surgery

Department of Urology

University of Miami Miller School of Medicine

University of Miami Health System

Miami

FL

Disclosures

LM is a consultant for Coloplast educational pelvic floor cadaver labs.

Acknowledgements

Dr G. Willy Davila and Dr Laura Martin would like to gratefully acknowledge Dr Alexandriah N. Alas, Dr Aimee Lynn Smith, Dr Marjorie Jean-Michel, and Dr Peter A. Castillo, the previous contributors to this topic.

Disclosures

ANA, ALS, MJM, and PAC declare that they have no competing interests.

Peer reviewers

Roger R. Dmochowski, MD, MMHC

Professor of Urology and Surgery

Department of Urology

Vanderbilt University Medical Center

Nashville

TN

Disclosures

RRD declares that he has no competing interests.

Heidi Brown, ​MD, MAS

Assistant Professor

Female Pelvic Medicine and Reconstructive Surgery

Departments of Obstetrics and Gynecology & Urology

University of Wisconsin School of Medicine and Public Health

Madison

WI

Disclosures

HB receives royalties for authorship from Wolters-Kluwer, Inc. and Springer, Inc. HB provides expert consultations for Grand Rounds, Inc. HB has research funding from the National Institutes of Health, serves on the Editorial Board of Female Pelvic Medicine and Reconstructive Surgery, and is on the Board of Directors for the American Urogynecologic Society (AUGS) and the Pelvic Floor Disorders Research Foundation.

Mohamed Y. Hammadeh, MSc (Urol), FEBU, FRCS (Eng. Urol), Diploma ME (UCL)

Consultant Urological Surgeon

Foundation Training Programme Director

South London Healthcare NHS Trust

Queen Elizabeth Hospital

London

UK

Disclosures

MYH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Obstetricians and Gynecologists. Practice bulletin no. 155: urinary incontinence in women. Nov 2015 [internet publication].Full text

European Association of Urology. Non-neurogenic female LUTS. 2025 [internet publication].Full text

National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. Jun 2019 [internet publication].Full text

Kobashi KC, Vasavada S, Bloschichak A, et al. Updates to surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU guideline (2023). J Urol. 2023 Jun;209(6):1091-98.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Fístula urogenital (fístulas uretrovaginal, ureterovaginal, uterovaginal e vesicovaginal)
    • Ureter ectópico
    • Infecção do trato urinário
    More Differentials

  • Guidelines

    • Non-neurogenic female LUTS
    • Urinary incontinence and pelvic organ prolapse in women: management
    More Guidelines

  • Patient information

    Incontinência urinária de esforço: como fazer exercícios para o assoalho pélvico

    Incontinência urinária de esforço em mulheres

    More Patient information
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