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Vaginal atrophy incontinence — DGM MCQ

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ModerateContinenceVaginal atrophy incontinenceDGM

A 76-year-old woman has urgency, dysuria and recurrent negative urine cultures. She is postmenopausal and has vaginal dryness and dyspareunia. Examination shows vulvovaginal atrophy. Current medicines include no regular medicines. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Consider topical vaginal oestrogen

Genitourinary syndrome of menopause can cause urinary symptoms with negative cultures, and topical vaginal oestrogen may help. Repeated antibiotics, oral steroids, catheterisation and diuretics do not address atrophy and may cause harm. Not every urinary symptom in older women is bacterial infection.

Reference: NICE NG123; NICE menopause guidance