Urinary incontinence: Correlation of history and brief office evaluation with multichannel urodynamic testing

Abstract

OBJECTIVE: Patients' histories of urinary incontinence and the results of several standard clinical tests were correlated with final diagnoses obtained by multichannel urodynamic testing. We used a combination of clinical test results to predict the final diagnoses. STUDY DESIGN: Ninety consecutive women with a primary complaint of urinary incontinence completed a standardized questionnaire and underwent a structured clinical examination consisting of several standard clinical tests. Each patient later underwent multichannel urodynamic testing to obtain a final diagnosis. RESULTS: Although the symptoms of stress incontinence were significantly associated with genuine stress incontinence and mixed incontinence, overlap in patients with detrusor instability did not allow the histories to be useful diagnostically. The only clinical tests showing significant association with the final diagnoses of incontinence were the cough stress test and single-channel medium-fill cystometry. Reliable prediction of the urodynamic diagnosis of incontinence could not be achieved with either of these two tests or with a combination of variables obtained by discriminant analysis. CONCLUSIONS: Women with complaints of urinary incontinence, especially those for whom surgery is contemplated, should undergo complete urodynamic evaluation when it is available. (AM J OSSTET GYNECOL 1992;166:1835-44.)