Clinical evaluation of urinary incontinence

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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Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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