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Overflow incontinence — DGM MCQ

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ModerateContinenceOverflow incontinenceDGM

An 82-year-old man has dribbling incontinence and a weak urinary stream. He feels incompletely empty and has a palpable bladder after voiding. Urine dipstick is negative. Current medicines include amitriptyline, tamsulosin and ramipril. What is the most appropriate assessment?

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Correct answer: D — Post-void residual bladder scan

A weak stream, dribbling and palpable bladder suggest chronic retention with overflow, best assessed by post-void residual bladder scan. Antimuscarinics may worsen retention, pelvic floor exercises alone miss obstruction, colonoscopy is irrelevant, and a negative dipstick does not exclude retention. Retention is an important reversible cause of incontinence and delirium.

Reference: NICE LUTS guidance; NICE NG123