Question

Chapter 7: Benign Disorders of the Female Reproductive Tract

1. Your client, a 37-year-old G5P5, is being seen for a complaint of urinary incontinence with activity. The provider completes the exam and diagnoses her with “stress incontinence secondary to natural changes following multiple childbirths.” The provider has asked you to educate the client about the diagnosis and to discuss the treatment and management of incontinence. (Learning Objectives 2 and 4)

1. What factors are related to this cause of stress incontinence?

2. What treatment options are available?

3. What psychosocial concerns would you discuss with the client?

Answer 1

Stress incontinence basically means leaking of urine under certain circumstances (pressure conditions) example coughing, sneezing . What we see here is a pregnant lady with gravida 5. So factors related are

1. Pressure: extra pressure on the bladder due to activities such as coughing, sneezing and laughing can increase the pressure and cause leaking of urine.

2. Hormones: hormones can affect the lining of the urethra and bladder. Any change in normal physiology can contribute to inconsistency

3. Health issues: certain already prevalent health conditions can contribute to this condition. For example Diabetes mellitus.

4 . Urinary tract infections: UTIs are way more common in females than males. The risk increases during pregnancy. And incontinence is a symptom of UTI.

Treatment options:

1. Exercise and fluid consumption

2. Healthy lifestyle and scheduling bladder voiding

3. Urethral inserts amd vaginal pessary can help

4. Certain surgeries can be performed

Psychosocial concerns

1. It is one of the commonest problems and it should be made clear that there is nothing to be embarrassed about.

2. One must be well prepared with protective undergarments and incontinence pads while going out.

3.There can problems during coitus. Ask her to talk to her partner about this and take precautions.

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