Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with involuntary leakage of urine associated with increased intra-abdominal pressure, including coughing, sneezing, laughing, or physical exertion. Denies urgency, frequency, or nocturia. No history of hematuria, dysuria, or pelvic pain. Quantify pad usage per day and impact on quality of life.
Clinical Examination Findings
Abdominal exam: Soft, non-tender, no palpable bladder. Pelvic exam: Urethral hypermobility noted on cough stress test. Pelvic organ prolapse (POP-Q) assessment: [Grade 0-IV]. Vaginal atrophy status: [Present/Absent]. Neurological exam: Normal perineal sensation and anal sphincter tone.
Treatment Protocol
Initial management: Pelvic floor muscle training (Kegel exercises) and lifestyle modifications (weight loss, fluid management). If conservative therapy fails: Consider mid-urethral sling (TVT/TOT) or urethral bulking agents. Follow-up: Urodynamic study to confirm diagnosis and exclude detrusor overactivity.