Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the recommended first-line approach for managing stress incontinence?

1. Surgery

2. Pelvic floor exercises

3. Antidepressants

4. Diet modification

The correct answer is: Pelvic floor exercises

The first-line approach for managing stress incontinence is pelvic floor exercises, often referred to as Kegel exercises. These exercises strengthen the pelvic floor muscles, which support the bladder and help control urination. When these muscles are weak or have been damaged, it can lead to stress incontinence, where involuntary leakage occurs during activities that put pressure on the bladder, such as coughing, sneezing, or exercising. Research has demonstrated that pelvic floor exercises can significantly improve symptoms of stress incontinence and, in many cases, can be as effective as surgical interventions. They are a non-invasive method that can be performed at home, making them a practical choice for many patients. The emphasis on this conservative management approach aligns with guidelines from various health organizations that encourage initiating treatment with behavioral and physical therapy options before considering more invasive procedures. Surgical options are typically reserved for cases that do not respond to conservative management, while antidepressants are not a standard treatment for this condition. Modifying diet may help with other types of urinary incontinence, but it is not specifically indicated for stress incontinence management. Therefore, focusing on pelvic floor exercises as the first-line approach is supported by evidence and clinical practice.