docswapna
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An otherwise healthy 72y woman, has uncontrollable voiding of small amounts of urine when she laughs. Postvoid volumes are small. There is no noctumal incontinence. No abnormality is found on physical examination except for some laxity of the pelvic floor musculature. what is the diagnosis?
1. bladder tumor --> partial outlet obstruction
2 detrussor overactivity
3 fibrosis of detrussor muscle
4 outlet incompetence
5 small infarct of pontine micturition center
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| mediocre
Forum Elite
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4--INCOMPETENCE
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| hope99
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agree
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| docarchana
Forum Guru
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detrussor overactivity - voiding during pressure conditions like coughing, laughing etc
outlet incompetence - voiding at all times.
so i think B is more suitable
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| fox
Forum Guru
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outlet incompetence....the clue is weak pelvic floor musculature
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| docarchana
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then how can we support "no nocturnal incontinence"?
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| fox
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bcos she's not gonna laugh & cry in her sleep!!! I mean ...no exertion during sleep.
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| docarchana
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yes ur right. so voiding shud occur even then if there is outlet incompetence.
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| Dr.Papez
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Outlet is not strong enough to hold high intravesical/intrabdominal pressure.
Detrussor hyperirritability lead to urgency, urge incontinence-not necessarily related to straining. typical straining related ic is called stress incontinence
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| docarchana
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so whats ur say, Dr.papez...
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| Dr.Papez
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D-outlet incompetence-leading to stress incontinence
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| docarchana
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thanku,, Dr.papez....
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| lq2006
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