A novel clinical classification for male urinary incontinence: MI-CRONS

Abstract

Introduction:The aim of this study is to develop a new simple and practical classification of male urinary incontinence (UI) based on the clinical features and type of urinary incontinence. Materials & methods:MI-CRONS classification is a system based on severity of incontinence and patients’ characteristics. Clinical evaluation of incontinence severity is based on preservation of voiding, proportion of void/lost urine, absorbable device usage, level of physical efforts that causes urine loss and nocturnal incontinence. Following patients’ characteristics of patients were included in classification system: history of radical prostatectomy, history of pelvic radiation, surgery for prostatic obstruction, neurogenic or non-neurogenic bladder disorders, and urethral strictures and disorders. This MI-CRONS classification system uses five uppercase Latin letters as follows: Male Incontinence — Cancer, Radiation, Obstruction, Neurogenic, Stricture. The classification could be used for stress, urgency, and mixed UI forms. Results:The new MI-CRONS classification system was applied to 85 of 86 patients evaluated in this retrospective study. Patients were classified by MI-CRONS to estimate an inclusiveness and complicity of proposed classification only. One patient was not classified using the new MI-CRONS classification due to history of bladder exstrophy and augmentation cystoplasty. Most of the men studied had a stress form of urinary incontinence and the most common types were 2 (n = 18) and 3 (n = 17) after radical prostatectomy. Conclusion:The MI-CRONS has demonstrated prompt potential for classifying male incontinence of any type. The classification is a simple tool to describe these patients and could be useful for daily practice and clinical trials. Although further multicenter studies are needed to evaluate the predictive value of this tool. A Delphi consensus would be proposed with international experts for the further development of MI-CRONS.