[Use of micturition cystourethrography in evaluation of urinary incontinence in women].

Miction cystourethrography (MCU) is an investigation of the conditions of suspension of the bladder. Assessment of the conditions of suspension has been employed by som urologists for 1) diagnosis of genuine stress incontinence (SI), 2) choice of operative procedure for SI and 3) assessment of the surgical result after operation for SI. It is generally agreed that MCU, as a routine method, does not contribute any important diagnostic information on account of the very low predictive values. Whether MCU can contribute information of significance in the choice of operative procedure for SI is still controversial. Recent investigations suggest that the suprapubic approach is more effective than vaginal procedures and that this should be preferred for SI, regardless of the type of possible suspension defect and the presence of slight to moderate cystocele. This reduces the significance of a meticulous radiological diagnosis. Whether large cystoceles should be operated upon vaginally and/or suprapubically is not yet elucidated but these are not indications for MCU as they can be diagnosed by gynaecological examination. Postoperative MCU has revealed poor correlation between cure and relief of a possible suspension defect. As MCU is a resource-demanding examination which may be difficult to interpret, it cannot be recommended as a routine in assessment of urinary incontinence in women.