A 52-Year-Old Postmenopausal Woman Comes to the Office Due to Urine

A 52-year-old postmenopausal woman comes to the office due to urine leakage with coughing and sneezing.  She has no dysuria, urgency, or changes in urinary frequency.  The patient has had 3 spontaneous vaginal deliveries.  On pelvic examination, there is mild vulvovaginal atrophy and anterior vaginal wall prolapse.  The remainder of the physical examination is normal.  The patient is advised to perform exercises to strengthen her pelvic floor as part of treatment for her symptoms.  Which of the following structures is the most likely target of the exercise?

A) Bulbospongiosus muscle
B) Detrusor muscle
C) Internal urethral sphincter
D) Levator ani muscle complex
E) Uterosacral ligament

Correct Answer:

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