Detection of urethral incompetence. Erect studies using the fluid-bridge test

The fluid-bridge test (FBT) detects the entry of urine into the proximal urethra during coughing. In this study it was applied in the investigation of incontinent patients when they were first supine and then standing up. The test results in 76 women with urinary incontinence and 27 women with normal urinary control are reported. When the test was performed erect at 0.5 cm from the urethrovesical junction, it was positive in 68 (90%) of the study group and 4 (15%) of the controls. The difference between the results in the 2 groups is highly significant (P less than 0.001). In 12 (16%) of the incontinent group the test at 0.5 cm became positive only when the subject was standing up, indicating that erect testing adds to the diagnostic efficiency of the method. Erect testing seems more relevant to the investigation of stress urinary incontinence. This study has shown that this is possible using simple urodynamic apparatus.