ID
HPI
O – How long have you been incontinent for? (acute vs. chronic)
P – Frequency
Q – Intermittent or constant dribble
S – How severe is the problem? (daily functioning, social)
T – Day or night.
What kind of urinary incontinence is it?
Urge – larger volumes, frequency, day and night
Stress – dripping with laughing, coughing, ↑ intra-abdominal pressure, daytime
Overflow – small, hesitancy, incomplete voiding
If onset is acute . . .
D delirium/dementia, stroke, Parkinson’s, cord compression
– recent onset confusion, disorientation, distractibility
– numbness, weakness of lower limbs
– CVA, trauma, metastatic cancer
I infection
– history of UTIs, dysuria, changes in frequency
A atrophic vaginitis
– irritation or burning in vagina, use of local estrogen cream, oral estrogen preparation
P pharmaceuticals
– diuretics, sedatives, anticholinergics
E endocrine
– DM (polyuria, polydipsia), hyperparathyroidism
R restricted mobility
S stool impaction (constipation)
stress
– coughing, sneezing, coughing
If onset is chronic . . .
Causes
– Bladder tumor or stone
– BPH
– Neurological deficits (CVA, Alzheimers, neoplasms, cord compression)
– Surgery
– Polyuria (DM, hypercalcemia)
PMHx
– Surgery (vaginal, pelvic, prostate)
– Childbirth