Importance of Urologic Assessment for Pelvic Organ Prolapse With Occult Incontinence

A Case Study

William E. Somerall, Jr., MD, MAEd; Lisa S. Pair, DNP, RN, WHNP-BC

Disclosures

Urol Nurs. 2020;40(5):245-247, 257. 

In This Article

Clinical Interaction

Mrs. V.P. is a 56-year-old female who, for the past 6 to 8 weeks, has felt an increasing sensation of vaginal fullness and pressure. Over the past week, she has noted a bulge to her vaginal introitus. The bulge is more prominent with bowel movements and while playing tennis. She denies menopausal symptoms except for occasional pain with intercourse due to dryness. Water-soluble lubricants significantly help the discomfort. With further questioning, she denies urinary or fecal incontinence.

The patient uses lisinopril for mild hypertension; she uses no hormonal therapy. She is a G4 P4004 who delivered all babies vaginally without complications following spontaneous labor. Her largest baby weighed 3940 grams (8 lb, 11 oz). At age 34, she had post-partum bilateral tubal ligation; at age 40, laparoscopic cholecystectomy; and at age 44, laparoscopically assisted total vaginal hysterectomy with ovarian preservation for abnormal uterine bleeding secondary to fibroids.

She is married, mutually monogamous, a non-smoker, and drinks 1 to 2 glasses of wine 3 to 4 times a week with meals. She plays community league tennis twice weekly.

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