DIFFERENTIAL-DIAGNOSIS OF DETRUSOR INSTABILITY AND STRESS-INCONTINENCE BY PATIENT HISTORY - THE GAUDENZ-INCONTINENCE-QUESTIONNAIRE REVISITED

Objective. To evaluate the validity of the Gaudenz-Incontinence-Questi onnaire in the differential diagnosis of genuine stress-incontinence a nd detrusor instability. Design. Diagnoses based on questionnaire-resu lts were compared to those following complete urogynecologic assessmen t including urodynamics in 1938 patients with lower urinary tract symp toms. Results. Sensitivity and specificity for diagnosis of stress-inc ontinence were 0.559 and 0.447, respectively, for detrusor instability 0.615 and 0.563, respectively. Conclusion. The low sensitivity and sp ecificity of the test do not justify its use as a diagnostic tool in p atients with urinary incontinence. These results show that the scores may be misleading in a large proportion of patients and should not the refore be the only determinant of diagnosis, nor should strategies be based on history alone.