Krinsky's Case Challenge, Case XVII: Incontinence When Sneezing or Laughing

Glenn Krinsky, MD


June 03, 2003


A 39-year-old woman reports to her primary caregiver incomplete voiding and urinary incontinence when sneezing or laughing. Physical examination demonstrates an enlarged uterus and a moderate-sized cystocele. The patient is referred for a dynamic pelvic floor magnetic resonance imaging (MRI) study to determine whether a concomitant rectocele or enterocele is present.

Sagittal dynamic MRI studies of the pelvic floor.

Sagittal dynamic MRI study depicts an incidental finding (arrow), which is likely the cause of the enlarged uterus.

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In this case, the clinical work-up and imaging findings are compatible with a diagnosis of:

  1. Rectocele

  2. Cystocele

  3. Enterocele

  4. Uterine prolapse

  5. None of the above

View the correct answer.


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