urinary incontinence can vary from the need to change underwear everyday from a few drops occasionally
irritative symptoms e.g. urgency and urge incontinence, frequency and nocturia - may be caused by detrusor instability or may be an adaptive behaviour secondary to stress incontinence
other causes of irritative symptoms to consider include:
chronic urinary tract infection
interstitial cystitis
bladder carcinoma
urogenital atrophy
alcohol or caffeine
other causes of frequency include:
habit
diabetes
excessive fluid intake
anxiety
drugs e.g. diuretics
women may report other symptoms e.g. hesitancy, poor flow, incomplete emptying - causes to consider include neurological (e.g. demyelination), obstruction, drugs (e.g. anticholinergics)
obstetric and gynaecological history - gynaecological surgery, pregnancies and types of delivery
medical history
diabetes can present with polyuria or a UTI
stress incontinence can be exacerbated by chronic respiratory disease
CCF may cause nocturia
irritative symptoms may occur secondary to chronic constipation
Notes (1):
bladder diaries
use bladder diaries in the initial assessment of women with urinary incontinence or overactive bladder. Encourage women to complete a minimum of 3 days of the diary covering variations in their usual activities, such as both working and leisure days
symptom scoring and quality-of-life assessment
use a validated urinary incontinence-specific symptom and quality-of-life questionnaire when therapies are being evaluated
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