Female urinary incontinence: comparative value of history and urodynamic investigations

In order to identify the role of urodynamic investigation in relation to urinary symptoms, the authors assessed the diagnostic value of history and of urodynamic investigation in female urinary incontinence. 154 patients presenting with urinary incontinence were investigated prospectively, by standardised history and investigation of bladder stability and investigation of bladder stability and of cervico-urethral closure function. Clinical and urodynamic diagnostic conclusions were compared. Urodynamic results were highly discordant in the presence of clinical 'erethism', whilst agreement was more marked in the case of stress incontinence. Urodynamic investigation may be indicated after failure of medical treatment in the case of 'dysfunction'. By contrast, it is essential in stress incontinence in order to identify the mechanism or detect subclinical 'dysfunction'.