[A special clinic for investigation of urinary incontinence in women]

This article describes the findings in 228 women with urinary incontinence consecutively referred to the outpatient clinic at the University Hospital in Trondheim. A urotherapist used a structured questionnaire to record the history and also gathered other relevant information, prior to the examination by the specialist in urogynaecology. The mean age (+/- SEM) was 49 years (+/- 1), and 96 women (42%) had been incontinent for more than ten years. Urodynamic investigations revealed stress incontinence in 58%, sensory urgency in 19%, motor urgency in 17%, and positive urethral closing pressure in 21%. Normal cystometry was found in 55% of the women. The urogynaecologist's clinical diagnosis was pure stress incontinence in 45%, pure urgency in 21% and mixed incontinence in 32%. Using a severity index, we found that 7% had mild, 25% moderate, and 68% severe urinary incontinence. General practitioners seem to refer fewer old women than we consider to be appropriate. GPs themselves should handle the primary investigations and conservative measures for the majority of their patients with urinary incontinence. Specialist services should on the other hand take care of the doubtful cases and of patients where non-surgical and simple therapeutic management has failed to achieve a cure.