[49F] Experiencing urinary incontinence with urgency and stress triggers

Patient Description

A 49-year-old female has been experiencing urinary incontinence for approximately one year. The incontinence occurs daily and is triggered by coughing and sudden urges to urinate, often leading to an inability to reach the bathroom in time. The patient does not report frequent urination, pain, burning sensations, or changes in urine color. She has a medical history of bone-on-bone hip arthritis but is not currently taking any medications. The patient consumes about a gallon of fluids daily and has no family history of urinary incontinence or bladder issues. She has experienced hot flashes, which may be indicative of menopausal symptoms. There are no known allergies or other pre-existing conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your urinary incontinence:

  1. Stress Incontinence: This type of incontinence occurs when physical movement or activity — such as coughing, sneezing, running, or heavy lifting — puts pressure on your bladder, causing urine leakage. It's common in women, especially after childbirth or menopause, due to weakened pelvic floor muscles.

  2. Urge Incontinence: This is characterized by a sudden, intense urge to urinate followed by an involuntary loss of urine. It can be caused by a variety of factors, including urinary tract infections, bladder irritants, or neurological conditions.

  3. Mixed Incontinence: This is a combination of stress and urge incontinence, which seems to align with your symptoms of leakage during coughing and sudden urges.

  4. Menopausal Changes: Hormonal changes during menopause can affect the bladder and urethra, potentially leading to incontinence.

Typical treatments for urinary incontinence may include pelvic floor exercises (Kegel exercises), lifestyle changes, bladder training, medications, or in some cases, surgery. It's important to consult with a healthcare provider for a proper diagnosis and treatment plan.

What you can do

While it's important to see a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Pelvic Floor Exercises: Strengthening your pelvic floor muscles through Kegel exercises can help reduce leakage. Try to do these exercises regularly.

  2. Bladder Training: This involves scheduling bathroom visits and gradually increasing the time between them to train your bladder to hold urine longer.

  3. Fluid Management: While staying hydrated is important, try to limit fluids that can irritate the bladder, such as caffeine and alcohol.

  4. Healthy Lifestyle: Maintaining a healthy weight and avoiding smoking can also help reduce symptoms.

  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider. This can help in identifying patterns or triggers.

What you should look out for

Seek medical attention if you experience any of the following:

  • Blood in your urine
  • Pain or burning sensation when urinating
  • Sudden changes in your symptoms
  • Any new or worsening symptoms

Remember, it's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. They can provide personalized advice and support based on your specific situation.

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1 mo ago


People Also Ask


What are the common causes of urinary incontinence in women?

Common causes of urinary incontinence in women include weakened pelvic floor muscles due to childbirth, hormonal changes during menopause, urinary tract infections, and certain neurological conditions. Stress incontinence and urge incontinence are the most common types.


How can menopause affect urinary incontinence?

Menopause can lead to urinary incontinence due to hormonal changes, particularly the decrease in estrogen, which can weaken the tissues of the bladder and urethra, leading to leakage.


What are some non-surgical treatments for urinary incontinence?

Non-surgical treatments for urinary incontinence include pelvic floor exercises (Kegel exercises), bladder training, lifestyle changes such as fluid management and weight loss, and medications that help control bladder function.


When should I see a doctor about urinary incontinence?

You should see a doctor about urinary incontinence if you experience symptoms that interfere with your daily life, such as frequent or severe leakage, or if you notice blood in your urine, pain during urination, or any sudden changes in your symptoms.


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