A 73-year-old woman comes to the clinic complaining of acute onset of urinary incontinence after recent hospitalization for total knee replacement. Over the last 3 days, she has had 5-10 episodes of spontaneous urinary leakage daily. She also has had small, loose bowel movements. The patient has no urgency, increased frequency, dysuria, hematuria, or involuntary leakage associated with coughing, sneezing, or laughing. There is no recent history of fever or chills.
Her other medical problems include hypertension, well-controlled type 2 diabetes mellitus with HbA1c of 6.9%, and chronic constipation. Her medications include metformin, glipizide, lisinopril, amlodipine, docusate, and oxycodone. She has not changed her diet or increased her caffeine intake. Her stable routine includes 1or 2 alcoholic beverages each night. She has 4 children, all of whom were delivered vaginally.
Her vital signs are within normal limits. The abdomen is distended and mildly tender to palpation in the lower quadrants. Rectal examination shows hard stool in the rectal vault. Pelvic examination shows no thinning or pallor of the vaginal mucosa and no evidence of vaginal wall prolapse.
Which of the following is the most appropriate next step in management of this patient?
A) Ciprofloxacin
B) Estrogen cream
C) Oxybutynin
D) Pelvic muscle exercises
E) Polyethylene glycol
Correct Answer:
Verified
Q777: A 28-year-old woman comes to the office
Q778: A 54-year-old woman with end-stage renal disease
Q779: A 40-year-old woman is referred for evaluation
Q780: A 43-year-old man comes to the physician
Q781: A 64-year-old man comes to the office
Q783: A 75-year-old man comes for follow-up 6
Q784: A 32-year-old woman comes to the physician
Q785: A 55-year-old man comes to the emergency
Q786: A 67-year-old man comes to the physician
Q787: A 52-year-old man comes to the physician
Unlock this Answer For Free Now!
View this answer and more for free by performing one of the following actions
Scan the QR code to install the App and get 2 free unlocks
Unlock quizzes for free by uploading documents