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Pelvic Relaxation and Urinary Stress Incontinence: Are Urodynamic Tests Always Necessary?

In less than two years we have evaluated 404 patients who were referred to our uro-gynecologic clinic, at the University of Bari, because of lower urinary tract problems: in 314 stress incontinence associated with pelvic relaxation was present. A critical review of the results obtained in 274 of these patients by a complete urodynamic work up arose the doubt whether this type of examination was essential for an accurate diagnosis of the incontinence and for the choice of the treatment in an unselected clinic population. In fact only 6 patients (2.1%) presented an unstable bladder, whereas the great majority suffered from urethral sphincter dysfunction, i.e, stress incontinence. As these data were in contrast to what is reported in literature (TURNER WARWICK and WHITESIDE, 1976; DRUTZ and MANDEL, 1979) this population was put to analysis. The relevant findings are (Table 1):