Urodynamics or history? Clinical decision-making in women presenting with urinary incontinence

Preoperative urodynamic testing is recommended by experts, but evidence for clinical benefit is limited.

To determine whether urodynamic stress incontinence could be confirmed in women presenting with a history of stress incontinence.

History and urodynamic diagnoses of 444 women presenting to a general unit between June 2003 and July 2007 are described.

Urodynamic Stress Incontinence (USI) or mixed USI and detrusor overactivity were observed in 61% reporting any stress incontinence. 15% who reported no stress incontinence had USI. Compared with a normal urodynamic diagnosis, incontinence occurred more frequently in all other diagnostic categories (P < 0.0001) and was worst in the USI and mixed groups (P < 0.0004).

Urodynamic Stress Incontinence is a more severe entity than stress incontinence diagnosed by history. It is yet to be established if this information benefits patients.