What is a cough stress test and when is it used?

• A. A questionnaire to assess urinary symptoms.
• B. A bedside test provoking leakage by coughing; used to confirm stress incontinence during evaluation.
• C. A surgical procedure to support the urethra.
• D. A urodynamic measure of detrusor function during coughing.

Answer: (B)

A cough stress test is a simple bedside evaluation where the patient is asked to cough vigorously while the clinician watches for leakage. It’s used to confirm stress urinary incontinence during an initial evaluation, especially when the history suggests leakage with effort, sneezing, or other increases in intra-abdominal pressure. A positive result—urine leaks with a cough—indicates failure of urethral closure under pressure and supports a diagnosis of stress incontinence rather than urge incontinence. It’s not a questionnaire, not a surgical procedure, and it doesn’t measure detrusor function like a urodynamic test.