[67F] Experiencing urinary dribbling with activity

Patient Description

A 67-year-old female reports experiencing a small dribble of urine for several years, occurring during activities such as coughing, sneezing, or exercising. She denies any pain or burning during urination and has not noticed changes in urinary frequency or urgency. The patient is postmenopausal and has not undergone any surgeries related to the bladder or pelvic area. Her medical history includes multiple sclerosis and fibromyalgia diagnosed in 1989, optic neuritis in 1995, and mild coronary artery disease in 2020. She has no known drug allergies. Current medications include Baclofen 20 mg four times daily, Pregabalin 300 mg twice daily, Methylphenidate 40 mg daily, Hydrocodone 10-325 mg up to four times daily, Temazepam 30 mg nightly, Amlodipine 2.5 mg in the morning, Duloxetine 50 mg twice daily, Hydrochlorothiazide 25 mg in the morning, Potassium 20 mg in the morning and twice in the evening, and Levothyroxine 150 mg at 3:00 am. She also takes over-the-counter Vitamin B, Vitamin D3, Folic acid, and Vitamin C daily.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, the dribbling you experience could be related to:

  • Stress Urinary Incontinence: This is common and occurs when physical activities like coughing, sneezing, or exercising put pressure on your bladder, leading to small leaks. It can be more common in postmenopausal women due to changes in pelvic floor muscles.

    • Treatment: Often involves pelvic floor exercises (Kegel exercises) to strengthen the muscles. In some cases, medications or surgical options may be considered.
  • Multiple Sclerosis (MS): MS can affect nerve signals to the bladder, leading to urinary symptoms.

    • Treatment: May include medications to manage bladder function and physical therapy.

What you can do

  1. Pelvic Floor Exercises: Try doing Kegel exercises regularly to strengthen your pelvic muscles. This can help reduce leakage.

  2. Bladder Training: Gradually increase the time between bathroom visits to train your bladder to hold urine longer.

  3. Lifestyle Modifications: Maintain a healthy weight, avoid caffeine and alcohol, and stay hydrated to help manage symptoms.

  4. Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

  5. Consult a Doctor: It's important to discuss these symptoms with your healthcare provider for a formal diagnosis and personalized treatment plan.

What you should look out for

  • Increased Frequency or Urgency: If you notice changes in how often you need to urinate or a sudden urge to go, consult your doctor.

  • Pain or Burning: If you develop pain or burning during urination, seek medical attention.

  • Worsening Symptoms: If your symptoms worsen or become more frequent, it's important to see a healthcare professional.

Remember, while this advice can be helpful, it's essential to consult with a healthcare provider for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What is stress urinary incontinence and how is it treated?

Stress urinary incontinence is a condition where small amounts of urine leak out during activities that put pressure on the bladder, such as coughing, sneezing, or exercising. It is often treated with pelvic floor exercises like Kegel exercises, and in some cases, medications or surgery may be considered.


Can multiple sclerosis affect bladder function?

Yes, multiple sclerosis can affect bladder function by disrupting nerve signals that control the bladder, leading to symptoms like urinary incontinence. Treatment may include medications to manage bladder function and physical therapy.


What are Kegel exercises and how can they help with urinary incontinence?

Kegel exercises are exercises that involve repeatedly contracting and relaxing the pelvic floor muscles. They can help strengthen these muscles, which may reduce urinary leakage and improve bladder control.


What lifestyle changes can help manage urinary incontinence symptoms?

Lifestyle changes that can help manage urinary incontinence include maintaining a healthy weight, avoiding caffeine and alcohol, staying hydrated, and practicing bladder training to increase the time between bathroom visits.


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