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Stress urinary incontinence — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareStress urinary incontinenceUSMLE Step 3

A 48-year-old woman reports urine leakage when coughing, jogging, or laughing for 8 months. She has had two vaginal deliveries. She has no dysuria, urgency, hematuria, neurologic symptoms, or pelvic pain. Urinalysis is normal. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: C — Pelvic floor weakness causing urethral hypermobility

Stress incontinence is leakage with increased intra-abdominal pressure due to urethral hypermobility or intrinsic sphincter deficiency.

Reference: ACOG Urinary Incontinence Practice Guidance