60-year-old woman comes to the clinic due to the persistent feeling of “always having to go to the bathroom.” For the past 3 years,
the patient has had urinary urgency followed by involuntary loss of urine 2 or 3 times per day She has dysuria and nocturia and
sometimes awakens to find her undergarments wet Menopause occurred at age 52 when a total laparoscopic hysterectomy with
bilateral salpingo-oophorectomy was performed for endometrial adenocarcinoma. Medical history is significant for recurrent urinary
tract infections during the past year The patient is not sexually active and takes no medications. On physical examination, the vulvar
skin shows reduced elasticity with labia minora retraction. The vaginal epithelium is smooth and has areas of patchy erythema. There
is no loss of urine with Valsalva maneuver, and a urinalysis and postvoid residual urine test are normal. Which of the following is the
most likely cause of this patient’s urinary symptoms?
- QA Chronic bladder pain syndrome
- 0 B. Estrogen deficiency
- 0 C. Incomplete bladder emptying
- 0 D. Urethral hypermobility
- 0 E. Vesicovaginal fistula formation
0 voters