Postmenopausal urinary problems

Detailed objective assessment of urinary symptoms provides information from which satisfactory treatment can be given. The fundamental investigations are history and clinical examination, endoscopy and two-channel cystometry (using several provocative tests). Detrusor dysfunction is a commoner cause of urinary symptoms than is generally realized and it cannot be diagnosed easily on clinical assessment. Initial treatment of all urinary problems should be conservative as the majority of patients benefit, and surgery should be carried out only after careful selection of patients and operative techniques.