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  1. #1
    maixungphong's Avatar
    maixungphong is offline Junior Member
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    What kind of incontinence is this

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    A 45 y/o G3P3 came into your clinic because she was having urinary incontinence. Her internal medicine doctor put her on Detropan (oxybutynin) but it did not get better. She stated that when she coughs, sneezes, or laughs she leaks urine.

    What type of urinary incontinence is this? Is Ditropan a good choice for this incontinence?
    USMLE ma`y lai. dday tao ddap. ma`y che^'t

  2. #2
    jagian is offline Newbie 510 points
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    Genuine stress incontinence

    The patient is having stress incontinence.
    ditropan or oxybutinin wont be useful in this case. instead it will be useful in case of hypertonic urge incontinence. For stress incontinence kegels exercise, or surgical therapy like urethropexy (MMK procedure ) can be done. or tension free vaginal tape procedure can be performed.

  3. #3
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    student-2 is offline Senior Member 510 points
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    Not enough info!!!! Can she stop the leakage when it starts? If yes then it's GSI if not it can be detrusor dyssynergia which is ussually associated with leakage in the supine position and of large amounts of urine.
    If it is dyssynergia the treatment is good but not enough. It requires also bladder retraining and also some other meds that I don't remember which right now

  4. #4
    veleznic is offline Newbie 510 points
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    Just for what you said about the clinical it sounds more like stress incontinence.

  5. #5
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    Stress it is. Could possibly be something more complicated than this however for board purposes it is Stress.

  6. #6
    AUCMD2006's Avatar
    AUCMD2006 is offline Ultimate Member 6129 points
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    i agree

    Quote Originally Posted by manleyjb View Post
    Stress it is. Could possibly be something more complicated than this however for board purposes it is Stress.

    i agree for step 2 it is stress ioncontinence. they will also likely ask what simple tests can you do or what is the next step in evaulation and you should know the cotton swab test and the degree of change needed to diagnose

    also you can use estrogen cream, alpha blockers, tca's to increase outlet tone. when all else fail do surgery
    AUCMD2006
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