40 year old Ms. Blair is a committed long-distance runner, and a mother of two boys. She is also embarrassed to describe her reason for coming to her physician.
For several months, each time Ms. Blair finishes her run, she feels an uncontrollable urge to urinate. This happens as soon as she stops running. She tries to suppress the urge, but cannot, and voids a small amount of urine while still in her running clothes and before she can enter her home. This does not happen at any other time during the day or at night—it only occurs the moment that she ends a run.
In addition to feeling uneasy about discussing the problem, she is anxious about possibly having a tumor. Health and medical history indicate no known health problems, no medications, no history of smoking, and a healthy diet. Ms. Blair assumes this problem came “out of the blue” and she must have a serious urinary tract condition.
A cystourethrogram, or X-ray of the bladder, is obtained, along with urinalysis and urine cultures. Physical examination is normal. The main diagnostic aid is the history, particularly the details about exactly when incontinence occurs. Ms. Blair does not have the usual incontinence risk factors, such as being overweight, smoking, or other diseases. However, she does have two risk factors: female gender and advancing age. In addition, changes resulting from pregnancy can weaken the sphincter muscle.
What type of incontinence did Ms. Blaire have?