What is most likely the diagnosis

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A 65-year-old woman comes to your geriatric clinic to establish care. About 6 months ago, she started to have urinary incontinence when she coughed or sneezed. Patient stopped going to the gym because of leakage of urine during exercise. She is living with her husband at home and able to walk 2 miles on regular basis. Her husband reports no memory or cognition problem. The medical history includes allergic rhinitis and GERD. Her only surgery was a cholecystectomy at age 50. She is taking aspirin (ASA) and omeprazole daily and drinks 1 cup of tea in the morning. She does not smoke or consume alcohol. The patient denies dysuria, hematuria, abdominal pain, fever, or chills. The physical examination reveals no palpable firmness in the abdomen, no cystocele, no fecal impaction, and no pedal edema. Leakage of urine is observed during the cough stress test. Her mini mental status examination score is 30/30.

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What is most likely the diagnosis? What is your next diagnostic step? What is the next step in therapy?

Reference no: EM133728955

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