Station 79
Racheal Thompson
Age: 45 year old female
Patient
Patient's Story (Role player’s brief)
Patient’s Story
Opening Statement: “Hi doctor, I’ve been having some trouble with leaking urine, and it’s been going on for years now, but it’s gotten worse recently and it’s really starting to affect my life.”
You are Racheal, a 45-year-old woman attending a video consultation to discuss urinary incontinence that started after the birth of your only child, seven (7) years ago. The delivery was via forceps. Initially, you experienced occasional urine leakage with coughing or sneezing, which you managed without seeking medical advice.
Over the last four months, however, the symptoms have become more bothersome. The leakage has become more frequent, and you now wear urinary pads all the time.
More recently (last 2-3 months), you’ve developed a frequent and urgent need to pass urine, and sometimes you don’t make it to the toilet in time. However, these are less frequent than the leakage that occurs with physical movement like coughing or sneezing.
If asked which type of leakage occurs most often, say: “It’s usually when I cough or sneeze”
You’ve started sitting closer to the toilet at work out of fear of having an accident. You now actively avoid sex with your partner because you’re worried you might experience urine leakage during intercourse. This has affected your confidence and your relationship, even though your partner is supportive.
You have no dragging sensation down below.
Social History: You live with your husband. You do not smoke or drink alcohol, and you avoid caffeine. You’ve been restricting your water intake in an attempt to control your symptoms, but this seems to have made things worse.
Your periods are regular (last menstrual period 2 weeks ago), and you’re not on any contraception, as your husband had a vasectomy. Your bowels are normal.
You have not seen a doctor about this before, but you now feel overwhelmed and frustrated. It’s starting to affect your quality of life, and you’ve reached the point where you want help.
Say no to any other symptoms asked.
Ideas: You wonder if you may have a prolapse from your delivery and think this might be causing your symptoms.
Concerns: You’re worried that you may have to wear urinary pads for the rest of your life.
Expectations: You hope the doctor can help explain what’s going on and offer treatment or support so you can regain control of your life.
Say NO to any other questions asked outside of the details already provided in the scenario. Accept anything offered to you by the doctor.