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Incontinence
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A 57 year old female describes her frustration with involuntary urine loss while she coughs, laughs or sneezes. She is very embarrassed by the incontinence and is concerned that the situation has been worsening over the past few years. The patient reveals that she has 5 children and all the deliveries where vaginal. Past medical history is unremarkable. The most likely diagnosis is:
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