Urinary incontinence and genital prolapse in the female: clinical, urodynamic and radiological examinations.

Clinical examination, cystometry, combined pressure-flow studies and colpocysto-urethrography were used to investigate 369 consecutive patients referred with symptoms of genital prolapse or urinary incontinence. The incidence of urinary incontinence in women seeking hospital investigation and therapy was 240/100 000 women per year. Three hundred and three complained of urinary incontinence, 21% of these had urge incontinence, 36% both urge and stress incontinence and 43% stress incontinence. There was no correlation between previous obstetric history and present symptoms, the severity and objective signs of incontinence or the urodynamic findings. Correlation was found between urge incontinence and the cystometric finding of overactive detrusor function. Stress incontinence as a symptom was well correlated with low-pressure micturition. Pelvic examination did not differentiate between patients with different types of urinary incontinence. Cystometry was essential for the investigation of vesical dysfunction. Urodynamic studies and colpocysto-urethrography were useful in the diagnosis of outlet disorders and suspension defects.