11-30-2010, 07:17 AM
A 63-year-old Black female presents to your
office complaining of leaking urine. She gets up
at night five times to urinate and occasionally
loses urine en route to the toilet. During the
daytime, she urinates every 45 minutes “to help
prevent the leakage.” She denies loss of urine
with coughing or sneezing. She has not had
dysuria or any other pelvic floor complaints.
She has a family history of diabetes. She drinks
several caffeinated beverages throughout the
day. On examination, her postvoid residual
urine is normal, and a urine dipstick shows 3+
glucose but is otherwise negative. Her abdominal
and pelvic examinations are normal.
Which of the following do you recommend
(A) surgery for her incontinence
(B) antibiotics for a UTI
© diuretic therapy
(D) timed voids, decrease in caffeine intake,
and screening for diabetes
(E) referral to a urologist for cystoscopy
office complaining of leaking urine. She gets up
at night five times to urinate and occasionally
loses urine en route to the toilet. During the
daytime, she urinates every 45 minutes “to help
prevent the leakage.” She denies loss of urine
with coughing or sneezing. She has not had
dysuria or any other pelvic floor complaints.
She has a family history of diabetes. She drinks
several caffeinated beverages throughout the
day. On examination, her postvoid residual
urine is normal, and a urine dipstick shows 3+
glucose but is otherwise negative. Her abdominal
and pelvic examinations are normal.
Which of the following do you recommend
(A) surgery for her incontinence
(B) antibiotics for a UTI
© diuretic therapy
(D) timed voids, decrease in caffeine intake,
and screening for diabetes
(E) referral to a urologist for cystoscopy