Urinary Leakage

A 63-year-old female returns for a follow-up regarding blood pressure. During ROS, the patient mentions that she sometimes has a little urinary leakage. The leakage has been happening for a few years but seems to be getting worse. Urinary leakage is a sign of urinary incontinence, which refers to accidental loss of urine. This condition is more common among older people, particularly women and it’s caused by various factors. One of the potential differential diagnoses for her condition is urinary incontinence (Aoki et al., 2017). Some of the signs/symptoms that could result in this diagnosis include the accidental urine leakage, restricted mobility, irritation, and constipation. The second differential diagnosis that could be applicable to the patient’s condition is overactive bladder (OAB), which is a condition associated with unexpected strong urge to void or frequent urination. In addition to these signs, she could be diagnosed with the condition if she wakes up at night to pass urine and urge incontinence.

Assessment or work-up for this patient is essential to determine an appropriate diagnosis for her condition. A comprehensive assessment involving medical history, urinalysis, physical assessment, and post-void residual volume (Aoki et al., 2017). When conducting the assessment, conditions requiring specialist referral will be excluded. Once the assessment has been carried out, the predominant symptom will help to diagnose the condition and direct the appropriate treatment. Non-pharmacological management approaches could be used in the treatment or management of her condition depending on the symptoms. As shown in clinical studies, some of these measures that could be employed include proper nutrition, weight loss, avoidance of constipation, and physical activity (DeMaagd & Davenport, 2012). Behavioral interventions could also be utilized in combination with drug therapy. Drug therapy or pharmacotherapy incorporates different medications or anticholinergic drugs.

References

Aoki, Y., Brown, H.W., Brubaker, L., Cornu, J.N., Daly, J.O. & Cartwright, R. (2017, July). Urinary Incontinence in Women. Nature Reviews Disease Primers, 3, 1-44.

DeMaagd, G.A. & Davenport, T.C. (2012, June). Management of Urinary Incontinence. Pharmacy and Therapeutics, 37(6), 345-361.