No. 127-The Evaluation of Stress Incontinence Prior to Primary Surgery.

OBJECTIVE

To provide clinical guidelines for the evaluation of women with stress urinary incontinence prior to primary anti-incontinence surgery.

OPTIONS: The modalities of evaluation range from basic pelvic examination through to the use of adjuncts including ultrasound and urodynamic testing.

OUTCOMES: These guidelines provide a comprehensive approach to the preoperative evaluation of urinary incontinence to ensure that excessive evaluation is avoided without sacrificing diagnostic accuracy.

EVIDENCE: Published opinions of experts, supplemented by evidence from clinical trials, where appropriate.

VALUES: The quality of the evidence is rated using the criteria described by the Canadian Task Force on the Periodic Health Examination.

BENEFITS, HARMS, AND COSTS: Comprehensive evaluation of women considering surgery to treat urinary incontinence is essential to rule out causes of incontinence that may not be amenable to surgical treatment. Simplifying the evaluation minimizes the discomfort and embarrassment potentially experienced by women.

RECOMMENDATIONS: VALIDATION: These guidelines have been approved by the Urogynaecology Committee and the Executive and Council of The Society of Obstetricians and Gynaecologists of Canada.