Question

Personal Information

Name: Mrs. Maggie Meriwether

Age: 56 years old

Gender: Female

Description

Mrs. Meriwether is a 56-year-old woman, who was apparently in good health until six months ago, at which point she started noticing an uncontrollable urge to urinate when she was exercising, lifting weights, sneezing, or coughing. The embarrassing part for her is that, although she has tried to suppress the urge, she has voided in her underwear very often. The problem has become more frequent, and she has to wear a sanitary pad constantly. The patient also shares that she has something protruding through her vagina. She is anxious because she thinks she has a tumor. After conducting a thorough medical interview and physical examination, the doctor diagnoses stress urinary incontinence and cystocele.

Our patient is a mother of four children with vaginal deliveries complicated by shoulder dystocia. During her last pregnancy, she had a whitish and cottage cheese-like vaginal discharge. A year ago, Mrs. Meriwether had an episode of gastroenteritis accompanied by profuse vomiting and diarrhea, which produced moderate dehydration and electrolyte and acid-base imbalances. Our patient also indicates she has had two episodes of right renal colic produced a renal lithiasis. Patient has no history of smoking or alcohol intake.

• Urinary system: Leakage of urine through the urethra during Valsalva maneuver
• Reproductive system: Soft mass protruding through the vagina, mostly when the patient is pushing

Answer the following

• State the symptoms from the signs in this patient.
• Did you find any remarkable detail in the personal and social history of our patient that can help to make the diagnosis?
• What results do you expect to find in the tests ordered?
• What are some future complications the patient is at risk of developing?

Answer 1

SIGNS AND SYMPTOMS OF THE PATIENT

* Frequent urination or urge to urinate

* Not feeling bladder relief immidiately after urinating

* Frequent UTI

* Discomfort or pain in the pelvis,lower abdomen

* Tissue protruding that may be tender or bleeding

REMARKEBLE FINDINGS

The cystocele is the result of weakening of supportive tissue between the bladder and the vaginal wall. So the patient is delivered 4 child because of that the chance pelvic muscle strain during the vaginal childbirth . And also she delivered baby with dystocia of shoulder it will increase more risk for weakening of the pelvic floor muscles and ligaments connecting them can cause cystocele.

This is remarkeble diagnosis from patient personal history.

TEST RESULTS

It will help to identifies grade of cystocele mild ,moderate or severe.

Cystometrography helps to understand the presssure volume relationship of bladders, and we get an expected result of no tumor is present.the xray images show the complete that might block normal urine flow.

FUTURE COMPLICATIONS

* IF left untreated may be kidney damage is present

* Recurrent Urinary infections

* problem with the sexual activity may present