A 52-year-old mother with a history of five full-term, vaginal deliveries reports that she is incontinent of small amounts of urine when she goes for her daily walk, laughs, or sneezes. She is otherwise healthy, but finds this embarrassing and extremely frustrating. What is the most likely cause of her symptoms? 1) Failure of higher brain centers to inhibit detrusor contraction.
2) Bladder expansion resulting in contraction of the detrusor muscle.
3) Impairment of neuroregulatory control of the sacral nerves S2, S3, S4.
4) Insufficient support of the bladder and proximal urethra from pelvic muscles and ligaments.
5) Impairment of voluntary control of smooth muscle of the internal urethral sphincter.