Differential diagnosis of detrusor instability and stress-incontinence by patient history: the Gaudenz-Incontinence-Questionnaire revisited.

OBJECTIVE

To evaluate the validity of the Gaudenz-Incontinence-Questionnaire in the differential diagnosis of genuine stress-incontinence and detrusor instability.

DESIGN

Diagnoses based on questionnaire-results were compared to those following complete urogynecologic assessment including urodynamics in 1938 patients with lower urinary tract symptoms.

RESULTS

Sensitivity and specificity for diagnosis of stress-incontinence were 0.559 and 0.447, respectively, for detrusor instability 0.615 and 0.563, respectively.

CONCLUSION

The low sensitivity and specificity of the test do not justify its use as a diagnostic tool in patients with urinary incontinence. These results show that the scores may be misleading in a large proportion of patients and should not therefore be the only determinant of diagnosis, nor should strategies be based on history alone.