Urinary Incontinence in women

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History and Physical Examination
A preliminary diagnosis of urinary incontinence can be made on the basis of a history, physical examination

and a few simple office and laboratory tests. Initial therapy may be based on these findings. If complex conditions are present or if initial treatments are unsuccessful, definitive specialized studies are required. Because urinary incontinence is a
common condition, patients being examined for another problem may mention episodes of urinary incontinence.

Table 1 lists a few key questions that can provide information on the severity

of urinary incontinence and help distinguish the major subtypes. If the patient answers affirmatively to these screening questions, a 24-hour "bladder diary" can be given to the patient to complete . The diary entries can then be reviewed at a subsequent office visit.

History
The medical history should also identify such contributing factors as diabetes, stroke, lumbar disc disease, chronic lung disease, fecal impaction and cognitive impairment. The obstetric and gynecologic history should include gravity; parity; the number of vaginal, instrument-assisted and cesarean deliveries; the time interval between deliveries; previous hysterectomy and/or vaginal or bladder surgery; pelvic radiotherapy; trauma; and estrogen status.

Because fecal impaction has been linked to urinary incontinence, a history that includes frequency of bowel movements, length of time to evacuate and whether the patient must splint her vagina or perineum during defecation should be obtained. Patients should also be questioned about fecal incontinence. Patients are even more reluctant to discuss fecal incontinence than urinary incontinence; thus, direct questioning is essential .

Table - 2 Commonly Used Drugs That Can Influence Bladder Function
Drug Side effect
Antidepressants,antipsychotics , sedatives/hypnotics Sedation, retention
(overflow)
Diuretics Frequency, urgency (OAB)
Caffeine Frequency, urgency (OAB)
Anticholinergics Retention (overflow)
Alcohol Sedation, frequency (OAB)
Narcotics Retention, constipation, sedation (OAB and overflow)
Alpha-adrenergic blockers Decreased urethral tone (stress incontinence)
Alpha-adrenergic agonists Increased urethral tone, retention (overflow)
Beta-adrenergic agonists Inhibited detrusor function, retention (overflow)
Calcium channel blockers Retention (overflow)
ACE inhibitors Cough (stress incontinence)


A complete list of all prescription and nonprescription drugs that the patient is taking should be obtained. When appropriate, discontinuation of these medications or substitution of appropriate alternative medications will often cure or significantly improve urinary incontinence.

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sexy12 

relax idea of exam i like that exam (Amanda)

JoeHeller 

It's super cereal. You should put your damn grandma in a wheelchair and take her to a doctor.

http://www.180medical.com/

sulochana 

My mother is 86. She passes urine on laughing, coughing etc. She canot move out because of incontinence. So I can't take her to a doctor.She is not diabetic. Can somebody please suggest a tested medicine for it. Thanks.

Lisa4588 

After my stroke is when it started for me. I'm sure that is just one of the results but can it be corrected without a pill?

esco198025 

Urinary Incontinence is a serious problem. I know, I had to deal with it with my mom/ This is a great article and will help many women

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