Question 102 (part 2) · LEK · Urinary incontinence
A 58-year-old female patient presented to the doctor with incontinence. Physical examination and history taking revealed the following: para 2 (normal vaginal deliveries); incontinent when coughing, sneezing, walking, running; urinalysis – no abnormalities detected, negative urine culture; the patient does not get up to go to the bathroom at night; on physical examination pelvic organ prolapse stage 2 according to POPQ was diagnosed; BMI – 40, a positive cough stress test. Which is the correct course of action :
- A. the use of oral solifenacin due to overactive bladder.
- B. surgical treatment of pelvic organ prolapse.
- C. Botox injection into the walls of the bladder.
- D. surgical treatment of stress incontinence following body weight reduction.
- E. uterine removal together with appendages followed by surgical treatment of stress incontinence.
Hint
Identify the type of incontinence from the history, then ask which modifiable factor must be addressed before any operation.
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