Question

67 yo F evaluated for urinary incontinence that has worsened over the past 2 years. She experiences incontinence when she laughs or sneezes but reports no dysuria, hematuria, or loss of continence at night.Most appropriate management?

Answer 1

A 67-year-old female with incontinence during laughter or sneezing likely has stress urinary incontinence and should manage it with Kegel exercises or, in severe cases, surgery.

Step-by-step explanation:

The 67-year-old female patient experiencing urinary incontinence when laughing or sneezing, without dysuria, hematuria, or night-time incontinence, is likely suffering from stress urinary incontinence. This condition is caused by a loss of support of the urethra, often due to the stretching of pelvic floor muscles, which can occur following childbirth. The most appropriate management would include pelvic muscle strengthening exercises, commonly known as Kegel exercises, which aim to reinforce the muscles that control urination. If the condition is severe, surgical options to improve bladder support may be considered. Unlike urge incontinence, which involves uncontrolled bladder contractions and a sudden, strong need to urinate, stress incontinence does not typically cause large amounts of urine leakage or a lack of warning before leakage occurs.