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June 25, 1955


JAMA. 1955;158(8):689. doi:10.1001/jama.1955.02960080065019

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To the Editor:—  Common things most commonly do occur. This remark would seem to apply to the editorial "Stress Incontinence" in The Journal, April 23, 1955, page 1500. The description of the test to determine if the patient has stress incontinence mentions the necessity of having the patient cough with a full bladder and observing whether urine escapes from the urethra. No mention is made of the etiological relationship of the habit of most women beyond their teens to hold their urine for long periods of time, usually because of modesty. This leads to not only a full bladder but in time to a distended bladder that exerts great pressure on the musculature supporting the urethra; then any stress increasing the intra-abdominal pressure is liable to result in incontinence of urine. This would seem to be the most common cause of stress incontinence in women. The first type of treatment

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