[Urodynamic study of urinary incontinence in women. For what purpose?]

Based on considerable personal experience and a rigorous and critical analysis of case-reports, a highly polemic subject is discussed. This fundamental article, prepared after deliberation and with discernment, is liable to close a debate by sweeping aside certain simplest principles established on bases supposedly scientific to the detriment of clinical observation. Recognition of bladder instability appears to be much more the domain of the an amnesis than of cystometry; transmission failure is a true myth confirmed neither by clinical or surgical findings, and is therefore of no utility for the surgical decision; incontinence due to urgency is perhaps less of an absolute contraindication to surgery than previously considered. It appears artificial to analyze a complex symptom such as urinary incontinence on results of urodynamic data alone, each women possessing a different balance. In contrast, knowledge of certain urodynamic parameters of this balance (particularly closure pressure) can assist prediction of chances of success of surgery. Opponents and proponents of urodynamic exploration of women with urinary incontinence should find in these comments a matter of reflection.