Urodynamics or history? Clinical decision-making in women presenting with urinary incontinence.
BACKGROUND
Preoperative urodynamic testing is recommended by experts, but evidence for clinical benefit is limited.


OBJECTIVE
To determine whether urodynamic stress incontinence could be confirmed in women presenting with a history of stress incontinence.


METHODS
History and urodynamic diagnoses of 444 women presenting to a general unit between June 2003 and July 2007 are described.


RESULTS
Urodynamic Stress Incontinence (USI) or mixed USI and detrusor overactivity were observed in 61% reporting any stress incontinence. 15% who reported no stress incontinence had USI. Compared with a normal urodynamic diagnosis, incontinence occurred more frequently in all other diagnostic categories (P < 0.0001) and was worst in the USI and mixed groups (P < 0.0004).


CONCLUSIONS
Urodynamic Stress Incontinence is a more severe entity than stress incontinence diagnosed by history. It is yet to be established if this information benefits patients.
Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia. paul.duggan@adelaide.edu.au
Paul
P
Duggan
D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000453:epidemiology; D053202:Urinary Incontinence, Urge / Q000175:diagnosis* / Q000453:epidemiology; D014563:Urodynamics