Thirty year old female complained of wetting her dress while coughing. Which one of the following conditions a nurse should suspect?
A. Cystocele B. Rectocele C. Enterocele D. Urethrocele
Correct Answer: A. Cystocele
Explanation
Answer: Stress Urinary Incontinence (SUI)
Explanation
A 30-year-old woman who complains of wetting her dress while coughing is showing a classic symptom of Stress Urinary Incontinence (SUI).
Why?
Stress urinary incontinence occurs when any increase in intra-abdominal pressure causes urine leakage.
Common triggers include:
- Coughing
- Sneezing
- Laughing
- Running or lifting
This happens due to weak pelvic floor muscles or urethral sphincter weakness, so the bladder cannot stay closed during sudden pressure changes.
Why not other conditions?
Condition Why it does NOT fit Urge incontinence Leakage is preceded by sudden strong urge to urinate, not by coughing. Overflow incontinence Involves dribbling, incomplete bladder emptying—not cough-related. Functional incontinence Due to mobility or cognitive issues, not present here.
Conclusion
The nurse should suspect Stress Urinary Incontinence, because coughing directly triggers urine leakage.
Other Options Details
Here are the descriptions of all the options:
A. Cystocele
A cystocele is the herniation or bulging of the bladder into the anterior vaginal wall.
Cause: Weakening of pelvic floor muscles, childbirth trauma, aging, menopause.
Symptoms: Vaginal bulge, urinary frequency, incomplete bladder emptying, stress incontinence.
B. Rectocele
A rectocele is the herniation or bulging of the rectum into the posterior vaginal wall.
Cause: Difficult childbirth, chronic constipation, pelvic muscle weakness.
Symptoms: Vaginal bulge, difficulty passing stool, need to support vaginal wall during defecation.
C. Enterocele
An enterocele is the herniation of small intestine and peritoneum into the upper part of the posterior vaginal wall, often between the rectum and vagina.
Cause: Weak pelvic floor after hysterectomy, increased abdominal pressure.
Symptoms: Pelvic pressure, backache, vaginal fullness, worsened symptoms when standing.
D. Urethrocele
A urethrocele is the downward displacement or prolapse of the urethra into the vagina.
Cause: Pelvic floor weakening, childbirth trauma.
Symptoms: Stress urinary incontinence, difficulty controlling urine, urethral discomfort.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group