Editing AUA: Overactive Bladder (2019) (section)

===== Physical exam (4) =====
# '''<span style="color:#ff0000">Abdominal exam</span>''' 
#*Assess for scars, masses, hernias and areas of tenderness as well as for suprapubic distension that may indicate urinary retention
# '''<span style="color:#ff0000">Rectal/genitourinary exam</span>''' 
#*'''To rule out''' 
#**'''Pelvic floor disorders (e.g., pelvic floor muscle spasticity, pain, pelvic organ prolapse) in females''' 
#**'''Prostatic pathology in males''' 
#*'''In menopausal females, atrophic vaginitis should be assessed''' as a possible contributing factor to incontinence symptoms. 
#*'''Assess for perineal skin for rash or breakdown.'''
#*'''Assess perineal sensation, rectal sphincter tone and ability to contract the anal sphincter''' to
#**Evaluate pelvic floor tone and potential ability to perform pelvic floor exercises (e.g., the ability to contract the levator ani muscles)
#**Rule out impaction and constipation.
# '''<span style="color:#ff0000">Assessment of lower extremities for edema</span>''' 
#*To assess for the potential for fluid shifts during periods of postural changes
#'''<span style="color:#ff0000">Patient’s attire and ability to dress independently</span>''' (as a surrogate for cognitive function)
#*The ability of the patient to dress independently is informative of sufficient motor skills related to toileting habits. This can provide information on the cognitive function of the patient, which is important to evaluate when considering anticholinergics.
#*A Mini-Mental State Examination (MMSE) should be conducted on all patients who may be at risk for cognitive impairment to determine whether symptoms are aggravated by cognitive problems, to ensure that they will be able to follow directions for behavioral therapy and/or to determine the degree of risk for cognitive decline with anti-muscarinic therapy.