A physician is called in to see a 78 years old woman living in an assisted living residence. She has been incontinent of urine since the past 2 days. Which of the following is not the likely cause for her incontinence?
  1. Urinary tract infection
  2. Severe depression
  3. Multiple myeloma
  4. Impacted stool

Answer: The answer is (c). Urinary tract infection is probably the most likely cause of urinary incontinence in this woman. The elderly usually do not present with fever or dysuria. Severe depression can also cause urinary incontinence. In immobile patients stool impaction can cause urinary incontinence though the reason for the same is not clearly known.