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Symptoms analysis for the diagnosis of genuine stress incontinence
1Department of Obstetrics & Gynaecology, Royal London Hospital, Whitechapel.
Objective:
To determine the accuracy of an analysis of symptoms alone for the diagnosis of genuine stress incontinence.
Design:
A comparison of results of symptoms analysis with urodynamic findings.
Setting:
A gynaecological video-urodynamic unit.
Subjects:
252 consecutive patients referred for urodynamic investigations.
Interventions:
A questionnaire of 20 symptoms of lower urinary tract dysfunction, midstream specimen of urine, pad testing, uroflowmetry, and video-cystourethrography.
Main Outcome Measures:
Using the urodynamic diagnosis as the 'gold standard', the accuracy of discriminant function analysis of symptoms was determined.
Results:
Symptoms analysis achieved a correct classification of 81% with a false positive rate of 16%. Use of an accumulative probability curve defines patients who fall into the equivocal range.
Conclusions:
All women presenting with incontinence should undergo preoperative urodynamic studies.