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a. anamnesis
patient identity
Main complaint
Since When is a complaint felt
Three Incontinence Questions (3IQ)
Did you leak urine:
When performing physical activity, such as coughing, sneezing, lifting, or exercise?
[indicates stress incontinence]
When you had the urge or feeling that you needed to empty your bladder, but could not
get to the toilet? [indicates urge incontinence]
Without physical activity or a sense of urgency? [indicates a cause other than stress or
urge]
b. Physical examination
General conditions
vital signs
Head to toe examination
Inspection of the external genitalia
Palpation Abdomen: No tumor or not, bladder palpable / no
Rectal toucher: fingered prostate hypertrophy, determining the strength of sphincter tone
c. Supporting investigation
regular leakage during stress maneuvers performed is strong evidence that it is not a stress
incontinence.
In men, the type of stress urinary incontinence is rare. The problem that usually occurs is
distinguishing detrusor overactivity with obstruction. The next stage is to look for the possibility
of hydronephrosis in men with residual urine exceeds 200 ml, and refer him or empty the bladder
(decompression). When hydronephrosis is not found but there is obstruction, the patient referred
for the possibility of surgery. For another, in patients with symptoms of urge incontinence
allegedly due to detrusor overactivity can be given the treatment. Medications to relax the
bladder should be avoided in patients with residual urine of 150 ml or more. The same approach
is also recommended in patients with cognitive impairment can be observed closely. Patients
elderly man without urge incontinence who failed to empirical therapy, and impaired cognitive
function should be consulted.
Reference:
Kong TK. Clinical Guidelines on Geriatric Urinary Incontinence. Desember 2003.