Symptoms analysis for the diagnosis of genuine stress incontinence

Abstract

Objective: To determine the accuracy of an analysis of symptoms alone for the diagnosis of genuine stress incontinence.

Design: A comparison of results of symptoms analysis with urodynamic findings.

Setting: A gynaecological video-urodynamic unit.

Subjects: 252 consecutive patients referred for urodynamic investigations.

Interventions: A questionnaire of 20 symptoms of lower urinary tract dysfunction, midstream specimen of urine, pad testing, uroflowmetry, and video-cystourethrography.

Main outcome measures: Using the urodynamic diagnosis as the 'gold standard', the accuracy of discriminant function analysis of symptoms was determined.

Results: Symptoms analysis achieved a correct classification of 81% with a false positive rate of 16%. Use of an accumulative probability curve defines patients who fall into the equivocal range.

Conclusions: All women presenting with incontinence should undergo preoperative urodynamic studies.