Are urodynamics necessary in female patients presenting with stress incontinence?

A urological and urodynamic database was used in a prospective study of female patients whose initial symptom was stress incontinence alone. The urodynamic diagnoses in 89 such patients were analysed against any additional symptoms. Fifty-four patients complained of stress incontinence without other symptoms and none of these had detrusor instability. One patient from a group of 25 who had frequency with stress incontinence had low bladder compliance but the others had normal urodynamic studies. Of the 10 patients with urgency in addition to stress incontinence, 5 had unstable bladders. A detailed urological history must be taken in all patients who are assessed for stress incontinence. Urodynamics are unnecessary in patients with stress incontinence alone but should be considered in those with additional urgency.