[52F] Experiencing urinary incontinence and vaginal symptoms post-surgery

Patient Description

A 52-year-old female is experiencing extreme itching and swelling of the vaginal area, along with swollen and painful lymph nodes on both sides of the pelvis. She reports urinary incontinence and frequent urination that began suddenly a few days ago. Additionally, she has noticed a yellow discharge that started as clear and gradually changed color. The patient has a significant surgical history, including a total hysterectomy and proctectomy earlier this year, followed by emergency surgery for vaginal cuff repair and a post-operative infection. She had a follow-up appointment three weeks ago, where sutures were still visible, and she is scheduled for another appointment soon. The patient is post-menopausal and has not experienced any fever, chills, pain, or burning sensation during urination, nor any unusual odor with the discharge. She is currently taking Fluoxetine, Ropinirole, and Propranolol, with no known allergies or over-the-counter medications. There is no recent travel or exposure to new environments that might have contributed to her symptoms.

Arora's Assessment

What might be happening

Based on your symptoms and recent surgical history, there are a few potential explanations for what you are experiencing:

Urinary Tract Infection (UTI): The sudden onset of urinary incontinence, frequent urination, and yellow discharge could indicate a urinary tract infection. UTIs are common after surgeries involving the pelvic area and can cause irritation and swelling.
Post-Surgical Complications: Given your recent surgeries, it's possible that your symptoms are related to healing or complications from the procedures. Swelling and discharge could be signs of an infection or inflammation in the surgical area.
Lymphadenopathy: The swelling and pain in your pelvic lymph nodes may be a response to infection or inflammation in the surrounding tissues.

Typical treatments for these conditions may include antibiotics for infections, pain management, and monitoring by your healthcare provider. Diagnostic tests such as urine analysis or imaging may be necessary to confirm the diagnosis.

What you can do

Urinary Symptoms and Discharge:

See your doctor: It's important to consult your healthcare provider as soon as possible, especially given your recent surgeries. They can perform tests to determine if you have an infection and prescribe appropriate treatment.
Stay hydrated: Drink plenty of water to help flush out any potential infection.
Avoid irritants: Use unscented and gentle hygiene products to avoid further irritation.

Swelling and Itching:

Warm compress: Apply a warm compress to the swollen lymph nodes to help reduce discomfort.
Avoid scratching: Try not to scratch the affected area to prevent further irritation or infection.

General Health:

Track symptoms: Use MDandMe to journal your symptoms, track progress, and share this information with your healthcare provider during your upcoming appointment.

What you should look out for

While your symptoms are concerning, they may not be life-threatening. However, you should seek medical attention if you experience any of the following: