Incontinence

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

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