[38F] Experiencing Urinary Incontinence and Frequent Urination

Patient Description

A 38-year-old female has been experiencing urinary incontinence and frequent urination for about a week. The incontinence is described as a sudden urge to urinate, with urine trickling down her legs before she can reach a toilet. This issue occurs both during the day and at night, and is also triggered by coughing or sneezing. Additionally, the patient wakes up 4-5 times a night with an urge to urinate, leading to significant daytime sleepiness. The patient has a history of recurring UTIs since last year, four C-sections, and a tubal ligation. Currently, she is taking Protonix and a prenatal vitamin twice daily. She has allergies to benzodiazepines, penicillin, the flu vaccine, the Dtap and Tdap vaccines, Geodon, and Latuda. There have been no recent changes in the color or odor of her urine, no blood in the urine, severe lower abdominal pain, fever, or chills reported.

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Arora's Assessment

What might be happening

Based on your symptoms, it's possible you might be experiencing:

  • Urinary Incontinence: This is a common condition where you lose control of your bladder. In your case, it seems like you might have urge incontinence, which is characterized by a sudden, intense urge to urinate followed by an involuntary loss of urine. This can be caused by various factors, including damage to the bladder's nerves, damage to other parts of the nervous system, damage to muscles, or conditions such as diabetes, neurological disorders, or urinary tract infections.

    • Treatment typically involves lifestyle changes, pelvic floor muscle exercises, bladder training, medications, or in some cases, surgery.
  • Overactive Bladder (OAB): This is a condition where the bladder can't hold urine normally, which can lead to urinary incontinence. Symptoms include a sudden urge to urinate, frequent urination, and nocturia (waking up from sleep to urinate).

    • Treatment usually involves lifestyle changes, bladder training, medications, or nerve stimulation.
  • Stress Incontinence: This is when physical movement or activity such as coughing, sneezing, running or heavy lifting puts pressure (stress) on your bladder, causing you to leak urine. This is more common in women who have had children.

    • Treatment can involve pelvic floor exercises, bladder training, weight loss, or in some cases, surgery.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider who can evaluate your symptoms and medical history to provide a proper diagnosis.

What you can do

While waiting for your appointment, you can:

  1. Keep a bladder diary: Note when, how much, and what kind of fluids you consume, when you urinate, the amount of urine you produce, and any associated symptoms.
  2. Practice pelvic floor exercises: Also known as Kegel exercises, these can strengthen your urinary sphincter and pelvic floor muscles, which can help control urination.
  3. Modify your fluid intake: Try to reduce your intake of fluids that can irritate the bladder, such as caffeine, alcohol, and acidic juices.

What you should look out for

Please seek immediate medical attention if you:

  • Notice blood in your urine
  • Have back pain, fever, or chills, which could indicate a kidney infection
  • Experience a sudden increase in frequency and urgency of urination
  • Have severe lower abdominal pain

Remember, it's important to consult with a healthcare provider for a proper diagnosis and treatment.

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9 mo ago

People Also Ask


What are the common causes of urinary incontinence in women?

Common causes of urinary incontinence in women include childbirth, hormonal changes during menopause, obesity, urinary tract infections, and certain neurological disorders. It can also be caused by weakened pelvic floor muscles or damage to the nerves controlling the bladder.


How can pelvic floor exercises help with urinary incontinence?

Pelvic floor exercises, also known as Kegel exercises, can help strengthen the muscles that support the bladder and urethra. This can improve bladder control and reduce the symptoms of urinary incontinence by preventing involuntary urine leakage.


What lifestyle changes can help manage overactive bladder symptoms?

Lifestyle changes that can help manage overactive bladder symptoms include reducing the intake of bladder irritants like caffeine and alcohol, maintaining a healthy weight, practicing timed voiding to train the bladder, and staying hydrated with water while avoiding excessive fluid intake.


When should I seek immediate medical attention for urinary issues?

You should seek immediate medical attention if you notice blood in your urine, experience severe lower abdominal pain, have back pain accompanied by fever or chills, or if there is a sudden increase in the frequency and urgency of urination, as these could indicate a more serious condition like a kidney infection.


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