Question

The patient is a 52-year old perimenopausal woman who reports a small loss of urine with coughing, laughing, and occasionally bending over. Recently she has started to leak urine just as she arrives in the bathroom but before she sits on the toilet. She stated her mother has had a continuing problem with incontinence for years and seldom leaves her home. The patient wants to continue to lead an active lifestyle and wants to discuss options for preventing progression of this embarrassing condition. What other information should you obtain from this patient? What type or types of incontinence is she most likely to have from the information she has provided thus far? Is this problem likely to be genetic? Why or why not? What will you tell her regarding options for care? She asks if there is anything she can do now to help reduce her urine leakage. How do you respond?

Answer 1

The term “urinary incontinence” refers to the uncontrolled release of urine or lack of voluntary control over micturition. In contrast, “urinary retention” is, failure to void the urine normally or completely. The possible causes of urinary incontinence in this women include,

• Pregnancy
• Age
• menopause
• Hysterectomy
• Obstruction in the urinary tract
• Urinary tract infection
• Vaginal delivery
• Neurological problems like Parkinson's disease, Myasthenia gravis, stroke, brain tumor, and spinal injury

Urinary incontinence can be genetic, and it is the common cause in majority of the cases. It is important to obtain the information about,

• Patient's history of childbirth
• Family history of urinary incontinence
• Past and present medical history
• Signs of urinary tract infection