IMPORTANT ASPECTS OF ANATOMY, PATHOPHYSIO LOGY AND DIAGNOSTIC PROCEDURES FOR THE THERAPY OF FEMALE URINARY-INCONTINENCE

Many aspects of the pathogenesis of urinary incontinence are poorly un derstood. Most studies show good results for physical therapy for inst ance for pelvic floor exercises Md biofeedback. Unfortunately most of these studies lack an objective diagnostic and neurophysiological asse ssment. This could be one reason for the strongly divergent therapeuti cal Success rates reported (30 to 90%). We recommend the use of object ive parameters, for instance the PAD test with standardized bladder vo lume and a neurophysiological and short urodynamic assessment as well as subjective parameters [satisfaction with the outcome of treatment m easured with the VAS (visual analog scale), documentation of the chang es in ADL (activities of daily living)] in future therapeutical studie s. A more precise assessment of the pathological cause of the impairme nt will help to develop optimal therapeutic procedures. Because of poo r documentation in the past the analysis of therapeutic failures and t he decision if mono- or complex physiotherapy is more appropriate has not been possible. This aspect will become even more important as the cost-effectiveness of treatments becomes a more important issue.