Scored urological history and urethrocystometry in the differential diagnosis of female urinary incontinence.

The diagnostic accuracy of a scored urological questionnaire in the differential diagnosis of female urinary incontinence was evaluated urodynamically in a series of 121 patients. A low urgency score (US) was present in 81% of the 57 patients with urodynamically proven stress urinary incontinence. About one third of the 37 patients with mixed incontinence had a low US. 6% of the 67 patients with a low US had unstable bladders. Of the 54 patients with a high US, 20% were stress incontinent, 37% mixed incontinent, 26% urge incontinent and 17% had no pathology on urethrocystometry. Degenerative changes in the urogenital area taking place with ageing may be responsible for high USs in some of the patients with pure stress incontinence. Urodynamic failures in the urethral closure function were identical in stress and mixed incontinence. It is recommended that patients with a high US should be investigated urodynamically before treatment.