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Bonney's test--fact or fiction?
British Journal of Obstetrics and Gynaecology
|February 1, 1987
Summary
The Bonney test is unreliable for diagnosing stress incontinence in women. Urodynamic studies show it increases urethral pressure but doesn't distinguish sphincter weakness from bladder instability, suggesting its discard.
Area of Science:
- Urology
- Female Pelvic Medicine
Background:
- Stress urinary incontinence (SUI) significantly impacts women's quality of life.
- Accurate diagnosis is crucial for effective treatment of SUI.
- The Bonney test has been historically used to assess for SUI.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Bonney test for true sphincter weakness stress incontinence.
- To compare Bonney test results with urodynamic findings in incontinent women.
Main Methods:
- Prospective urodynamic study involving 61 women with incontinence.
- Assessment of urethral closure pressure and abdominal-to-urethral impulse transmission during the Bonney test.
- Correlation of test results with urodynamic diagnosis of SUI and bladder instability.
Main Results:
- The Bonney test significantly increased urethral closure pressure and abdominal impulse transmission.
- These changes indicated urethral occlusion, not bladder neck elevation.
- The test failed to differentiate between patients with sphincter weakness and those with bladder instability.
Conclusions:
- The Bonney test is not a valid diagnostic tool for true sphincter weakness stress incontinence.
- Urodynamic assessment is superior for differentiating SUI from bladder instability.
- The Bonney test should be discontinued in clinical practice for SUI diagnosis.