I recently saw a 77 year-old Latina woman with complaints of strong urinary urgency resulting in incontinence, frequency every 2 hours with nocturia x4. She described urgency as “pressure in my bladder.” She reported that her symptoms were “terrible.” Her symptoms were longstanding but appeared to be worsening. She had undergone lumbar spinal fusion 18 months ago, her third back surgery. This was about the time symptoms worsened.