A 70-year-old woman comes to the physician for the evaluation of loss of urine for the last several months. She loses small amounts of urine without warning after coughing or sneezing. The patient has type 2 diabetes mellitus and was recently diagnosed with chronic obstructive pulmonary disease after evaluation for a chronic cough. Her only surgeries were 2 cesarean deliveries in her 20s. BMI is 30 kg/m². Pelvic examination shows leakage of urine from the urethra during the Valsalva maneuver. Postvoid residual volume and urinalysis are normal. Which of the following is the most likely cause of this patient's clinical presentation?

Question

Quizplus · Accepted Answer

Eductional Objective: Stress urinary incontinence (intermittent, involuntary leakage of urine) is caused by weakened pelvic floor muscle support that often occurs due to chronically increased intraabdominal pressure (eg, obesity, chronic cough, prior pregnancies).

A 70-Year-Old Woman Comes to the Physician for the Evaluation