A 70-year-old female with diabetes, no prolapse, and a 300-mL post void residual most likely has which type of incontinence?

A 70-year-old female with diabetes, no prolapse, and a 300-mL post void residual most likely has which type of incontinence?

• A. Stress
• B. Urge
• C. Overflow
• D. Functional

Answer: (C)

High post-void residual urine points to impaired bladder emptying. In a 70-year-old with diabetes, autonomic neuropathy can weaken detrusor contraction, so urine remains in the bladder after voiding. When there’s no prolapse to explain leakage, this emptied-with-difficulty pattern fits overflow incontinence, where the bladder overfills and leaks as it can’t empty completely. A residual of 300 mL is substantial and strongly supports this. Stress incontinence would involve leakage with activities that increase abdominal pressure and usually occurs with normal or minimal residual urine. Urge incontinence centers on sudden urgency and leakage from detrusor overactivity, typically with little residual urine. Functional incontinence stems from non-bladder factors such as mobility or cognition issues, not from bladder emptying.

High post-void residual urine points to impaired bladder emptying. In a 70-year-old with diabetes, autonomic neuropathy can weaken detrusor contraction, so urine remains in the bladder after voiding. When there’s no prolapse to explain leakage, this emptied-with-difficulty pattern fits overflow incontinence, where the bladder overfills and leaks as it can’t empty completely. A residual of 300 mL is substantial and strongly supports this.

Stress incontinence would involve leakage with activities that increase abdominal pressure and usually occurs with normal or minimal residual urine. Urge incontinence centers on sudden urgency and leakage from detrusor overactivity, typically with little residual urine. Functional incontinence stems from non-bladder factors such as mobility or cognition issues, not from bladder emptying.