detailed history
Last edited 05/2019
- urological history:
- symptoms may be mixed
- urinary incontinence can vary from the need to change underwear everyday
from a few drops occasionally
- irritative symptoms e.g. urgency and urge incontinence, frequency and
nocturia - may be caused by detrusor instability or may be an adaptive behaviour
secondary to stress incontinence
- other causes of irritative symptoms to consider include:
- chronic urinary tract infection
- interstitial cystitis
- bladder carcinoma
- urogenital atrophy
- alcohol or caffeine
- other causes of frequency include:
- habit
- diabetes
- excessive fluid intake
- anxiety
- drugs e.g. diuretics
- women may report other symptoms e.g. hesitancy, poor flow, incomplete
emptying - causes to consider include neurological (e.g. demyelination),
obstruction, drugs (e.g. anticholinergics)
- obstetric and gynaecological history - gynaecological surgery, pregnancies and types of delivery
- medical history
- diabetes can present with polyuria or a UTI
- stress incontinence can be exacerbated by chronic respiratory disease
- CCF may cause nocturia
- irritative symptoms may occur secondary to chronic constipation
Notes (1):
- bladder diaries
- use bladder diaries in the initial assessment of women with urinary incontinence or overactive bladder. Encourage women to complete a minimum of 3 days of the diary covering variations in their usual activities, such as both working and leisure days
- symptom scoring and quality-of-life assessment
- use a validated urinary incontinence-specific symptom and quality-of-life questionnaire when therapies are being evaluated
Reference: