URODYNAMIC ANALYSIS OF URINARY-INCONTINENCE SYMPTOMS IN WOMEN

One hundred eighty-eight women who complained of urinary incontinence and/or other lower urinary tract symptoms underwent thorough investigation in a special gynecologic urology and urodynamic unit. The evaluation included a detailed history using a computerized data retrieval form, physical examination, endoscopy (cystoscopy and female urethroscopy), and urodynamic evaluation, which included cystometry and simultaneous cystometry and urethral pressure profilometry. In 23 women, incontinence was the sole complaint and of this group, 87.0% had urodynamic evidence of true anatomic sphincter weakness. Of the entire group, 64.9% ( 122 188) complained of incontinence plus combinations of urgency, frequency, and nocturia. Of these 188 patients 85.2% had urodynemic evidence of bladder instability while only 71.3% had any evidence of sphincter weakness incontinence. Forty-three patients had additional complaints of dysuria and suprapubic pressure, and in this group 97.7% had evidence of sensory urgency and 51.2% demonstrated bladder instability. We found that questions classically considered to be pathognomonic of either true stress urinary incontinence or detrusor hyperreflexia had minimal predictive value. Among the study group 20.4% had previously undergone surgery for incontinence. A complaint of urinary incontinence is a symptom and not a diagnosis, and, although history is suggestive, it may be equally misleading. Adequate urodynamic assessment is essential in determining the underlying etiology and is mandatory before any form of surgical intervention is considered based only on history. © 1979.