Diagnostic Evaluation of Urinary Incontinence

Abstract

The variety of causes of female urinary incontinence demands an adequate and comprehensive preoperative diagnostic evaluation. Techniques used for the assessment of female urinary incontinence range from the simple gynecologic examination and cystoscopy to cystometry, sphincterometry, simultaneous urethrocystometry, cystourethrography, electromyography of the sphincter system, uroflowmetry, and even videographic cystourethrography with simultaneous pressure-flow measurement, the latter being the most modern and comprehensive study but also the most costly. At many centers the main selection criterion for a continence-restoring operation is the lateral cystourethrogram, which makes it possible, among other things, to accurately measure the posterior urethrovesical angle. In the past, the selection of candidates for surgical treatment has chiefly relied on a variety of roentgenographic techniques; and while these techniques have been significantly improved by the application of various catheters and contrast media, radiographic methods expose the patient to radiation and increase the risk of urinary tract infection.