A 65-year old woman complains of leakage of urine. The most common cause of this condition in such patient is

Ans. D. Unstable bladderAs patients age, the incidence of vesicle instability or unstable bladder increases dramatically. Although estrogen has been reported to decrease urgency, frequency, and nocturia in menopausal women, its effect on correction of stress urinary incontinence or vesicle instability is unclear. In the elderly population there are also many transient causes of incontinence that the physician should consider. These include dementia, medications (especially a-adrenergic blockers), decreased patient mobility, endocrine abnormalities (hypercalcemia, hypothyroidism), stool impaction, and urinary tract infections.