Differential Diagnosis
- Single most likely diagnosis
- Overactive bladder (OAB): The patient's symptoms of urinary urgency, involuntary loss of urine, dysuria, and nocturia are consistent with OAB. The absence of urine loss with coughing or sneezing and normal postvoid residual urine testing also support this diagnosis.
- Other Likely diagnoses
- Urinary tract infection (UTI): The patient's history of recurrent UTIs and current symptoms of dysuria and urinary urgency could indicate an ongoing or recurrent UTI.
- Genitourinary syndrome of menopause (GSM): The patient's symptoms of vaginal dryness, reduced elasticity, and patchy erythema, combined with her history of menopause and hysterectomy, suggest GSM, which can contribute to urinary symptoms.
- Do Not Miss
- Interstitial cystitis: This condition can cause urinary urgency, frequency, and dysuria, and can be debilitating if left untreated. Although less likely, it is essential to consider due to its potential impact on quality of life.
- Bladder cancer: Although rare, bladder cancer can cause urinary symptoms, including urgency and frequency. The patient's history of recurrent UTIs and hematuria (if present) would increase the suspicion for bladder cancer.
- Rare diagnoses
- Neurogenic bladder: This condition can cause urinary urgency, frequency, and incontinence due to nerve damage affecting bladder function. However, there is no clear indication of neurological damage or disease in the patient's history.
- Detrusor overactivity with impaired contractility: This condition can cause urinary urgency, frequency, and incontinence, but is less common and typically associated with neurological disorders or advanced age.