Evaluation of Stress Urinary Incontinence: State-of-the-Art Review

Abstract

Stress urinary incontinence (SUI) in women is an endemic and costly problem. It is associated with a significant burden on both a personal and community level. Despite its association with a poor quality of life, many women choose to live with the condition without seeking medical attention. The incidence of SUI, however, is escalating, and it is most evident in women living in residential aged care facilities. In most instances, diagnosis of SUI patients is straightforward with a demonstrable urinary leak upon coughing or employment of the Valsalva manoeuvre with a relatively full bladder. In these situations, further investigation with formal urodynamics is a matter of debate and there is no standard practice due to a lack of robust data to guide physicians. This review examines the pathophysiology and basic evaluation of SUI, and the current evidence supporting the utility of invasive urodynamic testing.