Incontinence: The Daily PANCE Blueprint

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Incontinence: The Daily PANCE Blueprint

A 62-year-old female with a history of obesity and chronic obstructive pulmonary disease presents to the clinic complaining of her urine “leaking.” She states it occurs when she laughs or coughs. Which of the following is the best initial treatment for this patient?

A. Midurethral sling
B. Weight loss and Kegel exercises
C. Duloxetine and tamsulosin
D. Urethropexy
E. Oxybutynin

Answer and topic summary

The answer is B. Weight loss and Kegel exercises

Stress incontinence is defined as the involuntary leakage of urine. It occurs when there is increased intra-abdominal pressure – such as sneezing or coughing or laughing. This happens due to intrinsic sphincter deficiency or urethral hypermobility. Risk factors include: obesity, menopause, pregnancy, high-impact activities, cough, etc. Diagnostic test include an urinary stress test. Initial treatment includes Kegel exercises, lifestyle changes, and vaginal pessary. Surgery can be offered if patient is refractory to conservative measures.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Genitourinary ⇒ Bladder disorders ⇒ Incontinence

Also covered as part of the Women's Health EOR and Emergency Medicine EOR topic lists

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