What does a positive cough stress test indicate?

• A. Detrusor overactivity.
• B. Stress incontinence due to urethral support failure.
• C. Incontinence due to overflow.
• D. No incontinence.

Answer: (B)

A cough stress test shows what happens to urine leakage when intra-abdominal pressure suddenly increases. If leakage occurs with a voluntary cough, the test is positive. This indicates stress incontinence due to urethral support failure—the urethra and bladder neck aren’t able to stay closed when pressure rises, often because of urethral hypermobility or weakened pelvic floor support. In contrast, leakage from detrusor overactivity (urge incontinence) typically happens with urgency and not just from coughing, and overflow incontinence involves continuous leakage from a poorly contracting bladder or obstruction, not a spike in leakage with a cough.