This is the involuntary leakage of urine associated with effort, e.g. coughing, laughing, or sneezing. Genuine stress incontinence refers to incontinence due to weakness of the pelvic floor and bladder outlet rather than due to detrusor instability. Contributing factors include cystocele (defects in the wall of the bladder), rectocele (defects in the wall of the rectum), and urethrocele (defects in the urethra).