ABSTRACT

This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage incontinence — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 55-year-old fit and muscular landscape gardener who returns to his general practitioner for review 6 months after his radical prostatectomy. However, since the surgery he has been troubled by urinary incontinence. He was told that this was a common post-operative problem which usually improved within 6 weeks; the urology specialist nurse has shown him pelvic floor exercises, but his incontinence has not improved. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.