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Urinary Incontinence Quiz
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Which lower urinary tract symptom is most characteristic of stress urinary incontinence?
- A Involuntary leakage of urine preceded by a sudden, compelling urge to void You picked ✕
- B Involuntary leakage of urine associated with a sensation of incomplete bladder emptying You picked ✕
- C Involuntary leakage of urine that occurs during sleep without a preceding urge You picked ✕
- D Involuntary leakage of urine that is continuous and unrelated to activity or posture You picked ✕
- E Involuntary leakage of urine during coughing or sneezing You picked ✓
Correct!
Incorrect
The answer is E: Involuntary leakage of urine during coughing or sneezing
Explanation
Why E is correct
See Lower Urinary Tract Symptoms. Option E is correct: stress urinary incontinence (SUI) is involuntary leakage of urine when pressure inside the abdomen rises, for example when coughing, sneezing, laughing or exercising. The word stress here means physical strain, not emotional stress. When the abdominal pressure rises it presses on the bladder, and if the urethral sphincter (the muscle ring that closes the outlet) and the pelvic floor cannot hold against that pressure, a little urine escapes. There is no warning, because the bladder is not contracting and there is no urge. The usual causes are weakened or damaged pelvic floor muscles, for example after childbirth. By contrast, urge incontinence is leakage with or soon after a sudden, intense urge to pass urine, and it comes from the detrusor (the bladder wall muscle) contracting when it should not. A simple memory aid: stress means strain, with leakage on cough, sneeze or exertion, whereas urge means urgency.
- Definition: Stress incontinence is leakage when abdominal pressure rises, such as on coughing or sneezing.
- Mechanism: The sphincter and pelvic floor cannot hold against the pressure, and there is no urge.
- Contrast: Urge incontinence follows a sudden urge and comes from the detrusor contracting.
Why the other options are incorrect
- A. Involuntary leakage of urine preceded by a sudden, compelling urge to void: A sudden compelling urge followed by leakage defines urge incontinence, which is caused by detrusor overactivity. Stress incontinence occurs without a preceding urge and is triggered by raised abdominal pressure. Your answer
- B. Involuntary leakage of urine associated with a sensation of incomplete bladder emptying: Leakage with a sensation of incomplete bladder emptying is more suggestive of overflow or voiding dysfunction than stress incontinence. Stress incontinence is leakage on effort with no sense of incomplete emptying. Your answer
- C. Involuntary leakage of urine that occurs during sleep without a preceding urge: Leakage during sleep without an urge is not characteristic of stress incontinence; it raises the possibility of nocturnal enuresis or another cause. Stress leakage follows rises in abdominal pressure. Your answer
- D. Involuntary leakage of urine that is continuous and unrelated to activity or posture: Continuous leakage unrelated to posture or activity suggests a fistula or severe sphincter deficiency rather than stress incontinence. Stress leakage is typically intermittent and triggered by physical effort. Your answer
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More questions from this set. Start the quiz to answer them and see each explanation.
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1
Which investigation should be performed in all women as part of the initial assessment of urinary incontinence?
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2
A 66-year-old man describes a noticeable delay before urine flow starts and a weak stream, even though his bladder feels full. His prostate feels smooth and enlarged. Which mechanism best explains the delay?
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