A 70-year-old woman complains of leakage of urine in small amounts. This occurs when laughing or coughing. It has also occurred while bending or exercising. The patient has five children who are concerned about her urinary problems. Which is the most likely type of urinary incontinence.

The 70-year-old woman with episodes of leaking small amounts of urine while laughing or coughing has stress incontinence. Stress incontinence occurs when the internal urethral sphincter fails to remain closed in response to increasing intra-abdominal pressure caused by laughing, coughing, or lifting. The problem is usually seen in postmenopausal women who have weakening of their pubococcygeus muscle after multiple childbirths.