[Diagnosis of female urinary incontinence. Progress with urodynamic functional diagnosis]

Owing to its frequency and severe consequences for the women affected, urinary incontinence poses a considerable problem. Our knowledge about its pathophysiology, as also the diagnostic and therapeutic possibilities, remain remarkably limited.

The main types of incontinence are stress, urge, reflex and overflow incontinence. Other forms are rare. A major diagnostic and therapeutic problem is posed by the mixed type, which can account for up to 60 percent.

Owing to the morphologically and functionally complex nature of the lower urinary tract, the diagnostic approach to incontinence must involve various levels, and comprises careful history taking, a thorough physical examination, and special urodynamic evaluation.

Abundant therapeutic approaches, both pharmacological and surgical, are available, but opinion as to what constitutes the best therapeutic concept varies greatly.

Despite the only moderate chances of successful treatment under realistic conditions, our present knowledge about the diagnosis and treatment of female urinary incontinence needs to become more widespread.