Answer to Question 1
ANS: D
Cystocele and prolapse of the uterus can affect pelvic floor anatomy and cause urinary changes, including incontinence and changes to the quality of the urinary stream. Overactive bladder is a cause of incontinence due to atrophic changes of the pelvic floor muscles.
Answer to Question 2
ANS: A
The most significant age-related changes in women are related to decreased estrogen influence. As estrogen levels decline, the epithelium and supporting tissues of the pelvis atrophy, resulting in friable mucosa and possible prolapse of the pelvic structures. The change in relationship of the pelvic structures results in hypermobility of the bladder base, pelvic muscle weakness, and urethral weakness, resulting in stress UI in women. The decreased glycogen content of the vaginal epithelium causes decreased lactic acid metabolism by Dderlein's bacillus, an increased pH of vaginal secretions, and, therefore, an increased risk for UTI.