امرأة عمرها ٤٨ سنة بعد ٤ ولادات، يتسرب منها البول عند الكحة والضحك ورفع الأشياء. ما التدخل الأول المناسب؟

A 48-year-old woman after four deliveries leaks urine when coughing, laughing or lifting. What is the appropriate first intervention?

1. A permanent urinary catheter to stop leakage completely
2. Voiding every hour throughout the day and night
3. Regular pelvic floor muscle exercises for several months
4. Restricting water to two cups a day only

Answer: C) Regular pelvic floor muscle exercises for several months. Stress incontinence results from pelvic floor weakness; first-line treatment is pelvic floor (Kegel) exercises, weight loss and treating chronic cough. Severe fluid restriction concentrates urine and irritates the bladder.