Based on patients symptoms and negative physical exam

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Based on patient's symptoms and negative physical exam, she has a typical Stress Incontinence. The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We can rule out urge incontinence because the denied urgency with her urination. We could not diagnose an overflow incontinence because there is nothing in her history that points toward any condition that would cause an overextended bladder such as diabetes or a neuropathic issue. The NP can consider her age as a factor in the development of Neurogenic Incontinence due to estrogen-deficiency post-menopause. Lack of estrogen results in vaginal atrophy that results in a relaxed external sphincter. Initially, the NP can suggest pelvic strengthening exercises (Kegel exercises). If these are unsuccessful, pessaries that provide pelvic support and surgery may be indicated.

Reference no: EM133712555

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