Classification of stress urinary incontinence

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Disorders

Background:

• Stress urinary incontinence (SUI) terminology varies based on clinical assessment (symptom/sign) and diagnostic investigations (urodynamic SUI).
• Classification often distinguishes intrinsic sphincter deficiency (ISD) from urethral hypermobility, which may be an oversimplification.
• Occult SUI can manifest after prolapse reduction.

Purpose of the Study:

• To review current classification systems for SUI.
• To evaluate the relevance of SUI classification in treatment selection and patient outcomes.

Main Methods:

• Review of classification systems based on clinical assessment and diagnostic testing (e.g., videourodynamics).
• Consideration of emerging technologies like ultrasound for future classification.
• Evaluation of urodynamic parameters like urethral pressure profilometry and Valsalva leak point pressure.

Main Results:

• Evidence supporting the influence of SUI classification on management outcomes is limited.
• Confounding factors complicate the generation of high-quality evidence for treatment selection based on classification.
• Practitioners use various tools to inform SUI treatment strategies.

Conclusions:

• The direct link between SUI classification and improved treatment outcomes requires further confirmation.
• There is a need to establish how SUI classification translates into effective treatment selection and better patient results.
• Current practice relies on a combination of diagnostic tools to guide SUI management.