Urodynamics. Is it useful for the gynaecologist?

The investigation of female incontinence is incomplete without the performance of a urodynamic evaluation. A diagnosis made only on a clinical history and examination is too inaccurate to allow for the proper management of the patient. In a personal series of 100 patients only 56% of those who were ultimately considered to have stress urinary incontinence were correctly diagnosed by clinical means as opposed to 97% correct using urodynamics. A urodynamic evaluation should be performed on most female patients suffering from urinary incontinence and is essential for patients who are being considered for surgery for recurrent stress incontinence. Mention is made of a group of 8 patients whose incontinence was due to a very low urethral closure pressure who responded well to phenylpropanolamine.