When is a standing cough stress test indicated in the evaluation of urinary incontinence?

Updated: Sep 23, 2019
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

If the cough leak test is initially performed with the patient in the lithotomy position and leakage is not observed, repeat this test with the patient in the standing position.

The patient stands upright with feet shoulder-width apart. Place a large towel under patient's feet. If pelvic prolapse is present, the prolapsed organ should be pushed up either with a pessary or gauze. Instruct patient to perform the Valsalva maneuver and cough in gradients (ie, mild, moderate, strong). Observable urine leakage in this position constitutes a positive test.


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