Evaluation of history and simple supine cystometry as a preoperative test in stress urinary incontinence

In a follow-up study the accuracy of a simple preoperative screening including history, Bonney 's test and supine cystometry was evaluated in patients with stress urinary incontinence. Based upon preoperative history alone, the patients were divided into two different groups, pure stress incontinence, and mixed stress and urge incontinence. All patients accepted had a normal supine cystometry at the preoperative work-up. The results of the operation were good in pure stress incontinence. In patients with mixed stress and urge incontinence the results were unsatisfactory and most of them presented a variety of urodynamic abnormalities postoperatively. Thus, in patients with pure stress incontinence, acceptance for surgery may be based upon a careful history, a simple supine cystometry and Bonney 's test, but in patients with mixed stress and urge incontinence a comprehensive clinical and urodynamic evaluation is mandatory. It seems that combination of detrusor instability and a history of pronounced urgency preoperatively calls for other therapeutic alternatives than operation.