Urinary Incontinence Hx Flashcards
General Incontinence Hx Structure
Timing of Incontinence Characteristics Associated Symptoms Prostate Hx PMH Drug Hx Social Hx Travel Hx Family History
Questions to ask about TIMING of incontinence
When did you first notice the incontinence?
When you leak is it intermittent or constantly dribbling?
How often does the incontinence occur in the daytime?
Do you wake in the night because you need to go?
Have you ever wet the bed?
Questions to ask about CHARACTERISTICS of incontinence
Could you describe what happens just before you pass water?
How much water do you pass?
Do you leak when you laugh/cough/sneeze?
Do you ever fail to make it to the loo on time?
Do you feel the need to pass water?
Associated Symptoms: UTI Prolapse Constipation Delirium/Dementia Spinal cord compression Red Flags
Is urination painful?
Is there any blood in urine?
Do you have any fevers?
Have you noticed a lump in that area? Any dragging sensation?
Have you been passing stool normally?
Any recent confusion/disorientation?
Any numbness or weakness in legs?
Any night sweats or weight loss?
Prostate History:
Hesitance
Poor flow
Terminal dribbling
Do you have difficulty starting when trying to pass water?
Do you have weak flow?
Do you dribble just after you’ve left the loo?
Questions to ask about PMH
Any surgery?
Do you have any children?
Diabetes?
Stroke?
Cancer?
Recurrent UTIs?
Atrophic Vaginitis:
Irritation or burning in vagina, do you use oestrogen creams?
Did you wet the bed when you were a child?
Questions to ask about drug history
Any allergies? Any new medications?
Diuretics?
Sedatives?
Anticholinergics?
Social History:
Occupation
Restricted mobility
Fluid intake
What job do you do?
Do you find your job to be stressful?
Do you have easy access to loo? How do you move around?
How much water do you drink? What do you tend to drink?
Smoking and alcohol intake
Family History/Travel History
Ask about relevant family history
Have you been abroad recently?
What are the acute causes of incontinence?
DIAPERS
Delirium/dementia Infection - recurrent UTIs Atrophic vaginitis - irritation/burning, oestrogen creams Pharmaceuticals Endocrine - diabetes Restricted mobility Stool impaction
What are chronic causes of incontinence?
PMH
Bladder tumour/stone
BPH
Neuro – Stroke, AD, neoplasms
Polyuria (diabetes, hypercalcaemia)
What kind of incontinence is it?
Urge incontinence:
Large volumes, frequent, day and night
Stress incontinence:
Dripping when laughing/coughing, daytime
Overflow incontinence:
Small amounts, hesitancy, incomplete voiding
