Question

Mrs. Tucker is a 45-year-old patient who presents with a complaint of urinary incontinence when she is engaging in physical activity. Which associated finding might explain this problem?

A. Hernial protrusion in the posterior wall of the vagina
B. Hernial protrusion through the anterior wall of the vagina
C. Symptoms associated with prementrual syndrome (PMS)
D. Enlargement and protrusion of the cervix into the vaginal vault

Answer 1

A hernial protrusion through the anterior wall of the vagina, known as a cystocele, can lead to stress urinary incontinence by allowing the bladder to bulge into the vagina. So, correct option is (b).

Step-by-step explanation:

Mrs. Tucker, a 45-year-old patient, complains of urinary incontinence when engaging in physical activity, which might be explained by an associated finding. Considering the anatomy and mechanisms of urinary incontinence, one potential cause could be a hernial protrusion through the anterior wall of the vagina.

This type of hernia, also known as a cystocele, occurs when the supportive tissue between a woman's bladder and vaginal wall weakens and allows the bladder to bulge into the vagina, potentially leading to stress incontinence. Stress incontinence happens when there is a sudden pressure on the bladder, often during physical activity, causing an unintentional loss of urine.

Stress urinary incontinence is typically caused by a loss of support of the urethra due to stretching of pelvic floor muscles, often as a result of childbirth. This condition is different from urge urinary incontinence, which involves uncontrolled contractions of the detrusor muscle. For stress incontinence, Kegel exercises to strengthen the pelvic muscles are recommended, and in more severe cases, surgery may be needed to improve bladder support.