According to Kegel1 stress incontinence affects about 5.5% of all adult women. Although the patient is usually a multipara with a cystocele,2 Nemir and Middleton3 found some degree of stress incontinence in 52.4% of 1,327 otherwise healthy nulliparous young college women. Many women with mild degrees of urinary incontinence do not complain of this symptom or even mention it in the course of giving a gynecologic history, and unless a complaint is made the examining physician may make no special effort to detect evidence of it. This would account for the wide discrepancy in reported incidence. The types of stress that result in urinary leakage include coughing, sneezing, laughing, lifting heavy objects, and walking downhill. Laughing is apt to be most troublesome because it consists of a series of repeated stresses. These patients have no nocturnal enuresis, but they tend to avoid social contacts during the day
STRESS INCONTINENCE. JAMA. 1955;157(17):1500. doi:10.1001/jama.1955.02950340030010
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