During a cough test in a neurologically intact patient, which finding can be assessed?

During a cough test in a neurologically intact patient, which finding can be assessed?

• A. Urethral hypermobility
• B. Anal wink
• C. Strength of the pelvic floor muscle
• D. Detrusor instability

Answer: (A)

The cough test checks how well the urethra and pelvic floor keep urine in when intraabdominal pressure rises. In a neurologically intact patient, coughing increases pressure and, if the urethra has become lax and hypermobile, it moves excessively and urine leaks. This leakage with coughing reveals urethral hypermobility as the mechanism behind stress incontinence, which is exactly what the test is designed to detect. The other options don’t fit this test: the anal wink is a sacral reflex test of neurological integrity, not continence mechanics; pelvic floor muscle strength is evaluated by palpation or specific strength testing rather than a cough test; detrusor instability refers to involuntary bladder contractions (urge incontinence) typically assessed with urodynamics, not through observing leakage during coughing.

The cough test checks how well the urethra and pelvic floor keep urine in when intraabdominal pressure rises. In a neurologically intact patient, coughing increases pressure and, if the urethra has become lax and hypermobile, it moves excessively and urine leaks. This leakage with coughing reveals urethral hypermobility as the mechanism behind stress incontinence, which is exactly what the test is designed to detect.

The other options don’t fit this test: the anal wink is a sacral reflex test of neurological integrity, not continence mechanics; pelvic floor muscle strength is evaluated by palpation or specific strength testing rather than a cough test; detrusor instability refers to involuntary bladder contractions (urge incontinence) typically assessed with urodynamics, not through observing leakage during coughing.