Current Role Of Urodynamic Testing In Female Urinary Incontinence

Female urinary incontinence is a frequent disease. Diagnostic work-up and treatment depend on the subjectively perceived suffering. The diagnostic tools available comprise a specific history and gynecologic examination including the cough test/pad test, analysis of a micturition protocol, and urogynecologic ultrasonography. In addition, urodynamic measurements contribute useful information for determining the type of urinary incontinence. Cystometry provides data on the motor and sensory function of the bladder in the differential diagnosis of urge incontinence (detrusor overactivity). A urethral pressure profile can yield information on stress urinary incontinence (disturbed urethral closure). Urodynamic testing is indicated in patients in whom primary (conservative or surgical) therapy failed, prior to any form of incontinence surgery, and to identify the type of incontinence in inconclusive cases. Urodynamic measurements alone do not yield a diagnosis but provide objective data on bladder and urethral function. This review presents a short outline of the pathophysiology of female urinary incontinence and discusses the range of urodynamic diagnostic tests currently available to the attending physician in planning therapy.