Botkin classification of urinary incontinence in men: MI-CRONS
DOI: https://dx.doi.org/10.18565/urology.2025.1.34-40
Kasyan G.R., Veliev E.I., Grigoryan B.L., Gvasalia B.R., Golubtsova E.N., Tomilov A.A., Bagatelia Z.A., Loran O.B., Pushkar D.Yu.
1) Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital, Moscow, Russia;
2) FGBOU VO “Russian University of Medicine”, Moscow, Russia;
3) Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
4) MINO FGBOU VO ROSBIOTEKH, Moscow, Russia
Aim. To develop a new practical classification of urinary incontinence (UI) in men based on clinical features and disease severity.
Materials and methods. The Botkin classification MI-CRONS is a system based on clinical features of patients and the degree of UI. Clinical assessment of the degree of UI is based on urination frequency, the ratio of spontaneous and involuntary urine output, the use of absorbent underwear, the level of physical efforts causing urine loss, and nocturia. The system uses five capital Russian or Latin letters: MI (Male Incontinentce) – C (cancer), R (radiation), O (obstruction), N (neurogenic and non-neurogenic bladder disorders), S (stricture). In an observational study, the medical records of 158 men with UI treated between March 2020 and April 2024 were analyzed. Twenty-one patients were prospectively enrolled in the study with a 24-hour pad test to assess the severity of UI. Patients were classified according to the new MI-CRONS classification of UI in men. A correlation analysis was performed between the MI-CRONS severity score and the pad test results.
Results. One patient could not be classified according to MI-CRONS due to a history of bladder exstrophy and sigmocystoplasty. The results of the 24-hour pad test in 21 patients showed a high correspondence between the subjective sensations and the objective severity of UI. According to the proposed classification, patients most commonly had UI types 2 and 3 after radical prostatectomy and urethral stricture or vesicourethral anastomosis. In the prospective part of the study (n=21), a significant positive correlation (r=0.97) was found between the volume of urine loss measured by the 24-hour pad test and the severity of UI according to the MI-CRONS classification.
Conclusions. The new Botkin classification MI-CRONS demonstrated its convenient and quick-to-use potential for classifying male UI of any type. The classification is a simple tool for characterizing men with UI and promises to be useful in routine clinical practice. Further multicenter studies are needed to assess its prognostic value.
About the Autors
Corresponding author: G.R. Kasyan – Ph.D., MD, professor at the Department of Urology of FGBOU VO “Russian University of Medicine”, Moscow, Russia, Head of the Urologic Department of S.P. Botkin’s State Clinical Hospital, Moscow, Russia; e-mail: g.kasyan@outlook.com
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