Botkin classification of urinary incontinence in men: MI-CRONS

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Abstract

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.

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About the authors

Gevorg R. Kasyan

S.P. Botkin State Clinical Hospital; FGBOU VO “Russian University of Medicine”

Author for correspondence.
Email: g.kasyan@outlook.com
ORCID iD: 0000-0001-7919-2217

Ph.D., MD, professor at the Department of Urology, Head of the Urologic Department

Russian Federation, Moscow; Moscow

Evgeniy I. Veliev

S.P. Botkin State Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: veliev64@gmail.com
ORCID iD: 0000-0002-1249-7224

Ph.D., MD, professor at the Department of Urology and Surgical Andrology, Head of the Department of Oncourology

Russian Federation, Moscow; Moscow

Bagrat L. Grigoryan

S.P. Botkin State Clinical Hospital; FGBOU VO “Russian University of Medicine”

Email: bagratgrigoryan15@gmail.com
ORCID iD: 0000-0002-7698-0653

senior assistant at the Department of Urology, Urologist at the Moscow Urologic Center

Russian Federation, Moscow; Moscow

Badri R. Gvasalia

S.P. Botkin State Clinical Hospital; FGBOU VO “Russian University of Medicine”; FGBOU VO ROSBIOTECH

Email: bgvasalia@gmail.com
ORCID iD: 0009-0004-8370-4392

Ph.D., MD, professor at the Department of Urology, Professor at the Department of Urology of MINO, Urologist at the Moscow Urologic Center

Russian Federation, Moscow; Moscow; Moscow

Elena N. Golubtsova

S.P. Botkin State Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: engolubtsova@yandex.ru
ORCID iD: 0000-0001-6651-2955

Ph.D., Head of the Academic Department, associate professor at the Department of Urology and Surgical Andrology, Urologist at the Moscow Urologic Center

Russian Federation, Moscow; Moscow

Andrey A. Tomilov

S.P. Botkin State Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: toandrei33@yandex.ru
ORCID iD: 0000-0001-9286-5930

Ph.D., assistant the Department of Urology and Surgical Andrology, Urologist at the Moscow Urologic Center

Russian Federation, Moscow; Moscow

Zurab A. Bagatelia

S.P. Botkin State Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: bagateliaz@mail.ru
ORCID iD: 0000-0001-5699-3695

Ph.D., MD, deputy Chief on Medical care of Moscow Urologic Center, Professor at the Department of Surgery

Russian Federation, Moscow; Moscow

Oleg B. Loran

S.P. Botkin State Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: olegloran@gmail.com
ORCID iD: 0000-0002-7531-1511

Ph.D., MD, professor, Academician of RAS, Honored Scientist of the Russian Federation, Head of Department of Urology and Surgical Andrology

Russian Federation, Moscow; Moscow

Dmitry Yu. Pushkar

S.P. Botkin State Clinical Hospital; FGBOU VO “Russian University of Medicine”

Email: pushkardm@mail.ru
ORCID iD: 0000-0002-6096-5723

Ph.D., MD, professor, Academician of RAS, Head of the Department of Urology, Head of the Moscow Urologic Center

Russian Federation, Moscow; Moscow

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2. Fig. 1. Types of NM in men according to the Botkin classification MI-CRONS

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3. Fig. 2. Distribution of patients according to the Botkin classification MI-CRONS and forms of NM

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