Kamla, a 48 years old lady underwent hysterectomy. On the seventh day, she developed fever, burning micturation and continuous urinary dribbling. She can also pass urine voluntarily. The diagnosis is :
**Core Concept**
Urinary retention and incontinence can occur due to injury to the nerves controlling the bladder, specifically the autonomic nervous system. The development of fever, burning micturation, and continuous urinary dribbling in a postoperative patient suggests an infection of the urinary tract, likely affecting the bladder or urethra.
**Why the Correct Answer is Right**
The symptoms described are consistent with a urinary tract infection (UTI), specifically a bladder or urethral infection. The presence of fever and burning micturation indicates inflammation of the urinary tract, while continuous urinary dribbling suggests an overflow incontinence due to an overactive bladder or urethral injury. The fact that Kamla can pass urine voluntarily implies that the lower urinary tract function is intact, but there may be a problem with bladder storage or emptying.
**Why Each Wrong Option is Incorrect**
- **Option A:** This option is not provided.
- **Option B:** While this option might seem plausible, it does not directly explain the symptoms of fever, burning micturation, and continuous urinary dribbling.
- **Option C:** This option is not directly related to the symptoms described, as it refers to a condition affecting the lower limb.
- **Option D:** This option is not provided.
**Clinical Pearl / High-Yield Fact**
The development of fever and urinary symptoms in a postoperative patient should prompt a search for a urinary tract infection, particularly in patients who have undergone pelvic surgery or have an indwelling catheter.
**Correct Answer: B. Stress incontinence is unlikely as the patient can pass urine voluntarily but incontinence is present. This is suggestive of an overactive bladder or a urethral injury leading to urinary incontinence.**