• Dr. Felicia Presenza MD CCFP

How D.I.A.P.E.R.S. can help YOU on your exam

No, we don't mean wearing them...


You are covering for a long term care facility and a nurse asks you to assess a 86 year old man who is presenting with urinary incontinence.


  1. Name 3 types/classifications of urinary incontinence.

  2. Describe 4 transient, short term or modifiable causes of incontinence.

  3. Name 4 conservative management strategies to advise patients who are presenting with urinary incontinence.

  4. Name 2 medications that can be used for patients presenting with urge incontinence/over active bladder.


  1. - Urge incontinence - Stress incontinence - Overflow/retention - Mixed, functional - Neurogenic

  2. Use mnemonic DIAPERS: Delirium Infection (UTI) Atrophic vaginitis Pharmaceuticals (anticholinergics, sedatives, hypnotics) Endocrine (diabetes) Retention (BPH)/Reduced mobility Stool impaction (constipation) Others to consider: excessive alcohol or caffeine intake

  3. - Prompted/scheduled voiding - Urge suppression/delayed voiding - Kegel exercises (although evidence for this is very limited) - Pelvic physiotherapy - Weight loss - Limit caffeine intake - Limit alcohol intake - Bowel regimen - Limit fluids after supper

  4. - Anti-muscarinic drugs (oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin) - Beta-adrenergic agonists (mirabegron) - For women; intravaginal estrogen - TCA (nortriptyline, imipramine)


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The only Canada-Wide CCFP exam course - created by two Family Doctors who wished this existed when we were residents, and are on a mission to help CCFP exam candidates. Disclosures: The Review Course founders have no conflicting commercial interests. As is the case with any private events hosted on a university campus or hospital, this event is not affiliated with nor endorsed by the host venues. Our materials are peer-reviewed and prepared by Canadian physicians; we do not guarantee that our preparation materials are representative of any Canadian examination and we do not provide questions from any other examination nor are they intended as medical advice. The College of Family Physicians of Canada does not affiliate with nor endorse any exam preparation course.