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Detailed history

Authoring team

  • 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:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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