CORRELATION OF THE CYSTOSCOPIC APPEARANCE AND FUNCTIONAL INTEGRITY OFTHE FEMALE URETHRAL SPHINCTERIC MECHANISM

Objectives. Urologists in the past, and many today, rely on the cystos copic appearance of the female urethra as a guide to its functional in tegrity. To assess the accuracy of this approach better, we compared t he cystoscopic appearance of the bladder neck and proximal urethra to the functional integrity of this mechanism during videourodynamic stud ies. Methods. One hundred consecutive videourodynamic studies were rev iewed on female patients with more complex types of urinary incontinen ce. Reports of their cystoscopic examinations were reviewed and result s compared. Results. Significant dysfunction of the intrinsic mechanis m was noted in 36% of the patients (26% moderate dysfunction and 10% s evere dysfunction) on video studies. Cystoscopy underestimated these d eficits 74% and 44% of the time, respectively, in the moderate and sev ere dysfunction groups. Conclusions. We conclude that the cystoscopic appearance of the bladder neck and proximal urethra cannot predict the functional integrity of this mechanism.