A. Duration, characteristics, and severity of the incontinence, precipitating factors and reversible causes should be assessed. Dysuria, urgency, pelvic pain, dyspareunia, constipation, fecal incontinence, pelvic prolapse, or abnormal vaginal discharge should be sought. A history of diabetes, thyroid disease, spinal cord injury, cerebral vascular accidents, urethral sphincter damage, or fistula conditions should be excluded.
B. Estrogen status should be determined because hypoestrogenism can contribute to recurrent cystitis, detrusor instability, and stress incontinence. Patients should be questioned about recurrent urinary tract infections, kidney stones, bladder pain, or hematuria.
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