What happens in genuine stress incontinence?

In genuine stress incontinence, urine is involuntarily leaked during physical exertion that increases intra-abdominal pressure, such as coughing, sneezing, laughing, jumping, or running. This occurs due to an underlying weakness or damage to the muscles and surrounding tissues that provide support to the urethra and bladder neck. As a result, the sphincter mechanisms are unable to adequately hold or resist the increased abdominal pressure, leading to urine leakage.