Predictive value of urethroscopy as compared to urodynamics in the diagnosis of genuine stress incontinence.

A retrospective chart review was undertaken of 204 patients who underwent dynamic urethroscopy. Ninety-nine patients with a diagnosis of genuine stress incontinence were evaluated urodynamically and urethroscopically to determine the predictive accuracy of the sensitivity and specificity of each of these diagnostic modalities. The urodynamic cough profile was both highly reactive and specific for genuine stress incontinence, with sensitivity and specificity of 95% and 100%, respectively, whereas dynamic urethroscopy yielded sensitivity and specificity of 60.2% and 79.1%, respectively. Dynamic urethroscopy is a relatively insensitive predictor of genuine stress incontinence, with many equivocal findings (11%) as well. The urodynamic cough urethral pressure profile is recommended for diagnosing this condition.