A patient leaks small amounts during exercise but not at night. This history is typical of which type?

A patient leaks small amounts during exercise but not at night. This history is typical of which type?

• A. Reflex incontinence
• B. Mixed stress-urge incontinence
• C. Stress incontinence
• D. Urge incontinence

Answer: (C)

This scenario points to stress incontinence. Leakage with physical activity occurs when increased intra-abdominal pressure—from exercise, coughing, or lifting—overcomes the urethral closure due to pelvic floor weakness or urethral support deficiency. The fact that leakage happens with activity but not at night suggests it isn’t driven by detrusor overactivity or a strong urge to void, which would indicate urge incontinence. Reflex incontinence tends to occur due to neurological issues and isn’t specifically tied to exertion. Mixed incontinence would show both stress and urge symptoms, which isn’t evident here. So the small leaks during exercise, with no nighttime or urge symptoms, best fit stress incontinence.

This scenario points to stress incontinence. Leakage with physical activity occurs when increased intra-abdominal pressure—from exercise, coughing, or lifting—overcomes the urethral closure due to pelvic floor weakness or urethral support deficiency. The fact that leakage happens with activity but not at night suggests it isn’t driven by detrusor overactivity or a strong urge to void, which would indicate urge incontinence. Reflex incontinence tends to occur due to neurological issues and isn’t specifically tied to exertion. Mixed incontinence would show both stress and urge symptoms, which isn’t evident here. So the small leaks during exercise, with no nighttime or urge symptoms, best fit stress incontinence.