Stress Incontinence

1. Stress incontinence is the involuntary loss of urine produced by coughing, laughing or exercising. The underlying abnormality is typically urethral hypermobility caused by a failure of the anatomic supports of the bladder neck. Loss of bladder neck support is often attributed to injury occurring during vaginal delivery.

2. The lack of normal intrinsic pressure within the urethra--known as intrinsic urethral sphincter deficiency--is another factor leading to stress incontinence. Advanced age, inadequate estrogen levels, previous vaginal surgery and certain neurologic lesions are associated with poor urethral sphincter function.

B. Overactive Bladder. Involuntary loss of urine preceded by a strong urge to void, whether or not the bladder is full, is a symptom of the condition commonly referred to as "urge incontinence." Other commonly used terms such as detrusor instability and detrusor hyperreflexia refer to involuntary detrusor contractions observed during urodynamic studies.

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