Recurrent urinary incontinence

A 69 y/o female, smoker, G 3 P 3, postmenopausal for 19 years, came for recurrent urinary incontinence and nicturia. She also presented a depressive disorder and dyslipidemia. Previous gynecological examinations presented no pathological signs. The patient reported urge incontinence and nicturia. Clinical examination was unremarkable: the evaluation of sensibility and reflexes was normal and pelvic organ prolapse or urinary incontinence were absent during Valsalva maneuvers. Urinalysis did not present any pathologic findings. TVS shows a thickened endometrium and irregularities in the cavity contour. What is your opinion?

* Causes of Urinary Incontinence --- Local factors , as in this case all are normal according narration stated ---- Neurogenic factors , must scrutinised as she also presented a depressive disorder, hense may under antipsychotic medicine it may cause incontinence * USG findings regarding Endometrial thickness & irregularities must look in to * One of Image shows vascular impedance on Dopper scan must investigated by Cystoscopy
Thickened endometrium in post menopausal women: plan hysteroscopy guided biopsy to rule out carcinoma Her urinary complains sound to be psychological, consult a psychiatrist, and also a urologist
Antidepressant , perineal exercises, for urinary problems . Currattage of Endometrial thickness for histopathology to rule out carcinoma to be done
Adv perineal exercises Treat dyslipidemia How mich is the endometrial thickness in mm
Endometrial polyps ? Ca adv histopathology and cyst