Urinary incontinence in the elderly female: prediction in diagnosis and outcome of management.

An algorithmic approach to the diagnosis of urinary incontinence in elderly females has been evaluated in a prospective series of 65 patients by comparing the clinical diagnosis arrived at using a modified form of a published algorithm with the subsequent urodynamic findings. The general validity of the concept was confirmed. The major errors in clinical diagnosis occurred in subjects with stress incontinence, emphasizing that presentation with this symptom was likely to warrant urodynamic study. In patients with detrusor instability it was shown to be possible to predict the likely response to conventional management of their incontinence after three months, on the basis of an arithmetic score derived from the cystometric findings.