Simple screening for urinary incontinence in the elderly: comparison of simple and multichannel cystometry

Urinary incontinence is a major cause of suffering and disability especially in the elderly. Accurate diagnosis is important to optimize treatment and multichannel cystometry is regarded as the gold standard. Simple cystometry is a technique of bedside cystometry using a single lumen catheter and filling syringe. Simple cystometry was compared with multichannel cystometry in 83 patients (mean age 73.5 years) and was found to have a specificity of 75 percent and a sensitivity of 88 percent for the diagnosis of detrusor instability. Simple cystometry is a quick, easy, and useful test which can be readily performed in the elderly by a doctor or trained nurse. Residual urine measurement, testing for stress incontinence, and estimation of flow rate can be performed at the same time. It can enable the most appropriate treatment to be initiated by improving the diagnostic accuracy of the clinical assessment when more complex resources and expertise is not available. In a proportion of patients further referral and investigation may be necessary.