A 33 year old woman complains of waking in the middle of the night to rush to the toilet. Most of the time, she does not make it to the toilet in time and she wets herself. What is the SINGLE most likely diagnosis?
A. Stress incontinence
B. Urge incontinence
C. Mixed incontinence
D. Overflow incontinence
E. Urethrovaginal fistula
This is the common presentation of urge incontinence. See below for the description of the types of urinary incontinence: Urge incontinence / overactive bladder (OAB) → is due to detrusor over activity. Common complain is “when I have to go to the toilet, I really have to go” or “I have the desire to pass urine and sometimes urine leaks before I have time to get to the toilet” Stress incontinence → leaking small amounts of urine when coughing or laughing. Usually with a history of many vaginal deliveries as this would weaken the pelvic floor muscles. Mixed incontinence → a mix of both urge and stress incontinence Overflow incontinence → involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. Occurs in people who have a blockage of the bladder outlet (benign prostatic hyperplasia, prostate cancer, or narrowing of the urethra), or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Urethrovaginal fistula → Opening between vagina and urethra. Common complaint is “ there is continual leakage of urine from my vagina” or “my vagina has a foul smell”.