Present illness : A 74 year old female described the insidious onset of increasing frequency, urgency, mixed urinary incontinence and suprapubic discomfort since past 12 months. She had been treated by her GP for recurrent culture proven Proteus mirabilis UTIs. Following an episode of painless vaginal bleeding 6 months after the initial onset of her urinary symptoms, she was referred to gynecological services for urgent investigation of postmenopausal bleeding. Past medical history : Her past medical history was notable only for a history of COPD.
She is an active smoker with a 20 year smoking pack history. She had never undergone any abdominopelvic surgery. She has 3 children who were all delivered via the normal vaginal route without any complications. An intrauterine contraceptive device (IUD) was inserted after the birth of her youngest child 42 years previously which was presumed…
