Assessment and investigations for urinary incontinence

Assessment of a woman complaining of urinary incontinence includes full uro logical, gynaecological, medical, surgical and drug histories. General, neu rological, abdominal and pelvic examinations are undertaken and with the hi story, enable a presumptive diagnosis to be formulated. Investigations for incontinence should be selected to suit the individual woman's need. Non-sp ecialist investigations include urine testing, completion of a urinary diar y and symptom score, pad testing, measurement of residual urine volume and biochemical tests. Specialist investigations include uroflowmetry, conventi onal and ambulatory cystometry, urethral pressure profilometry and measurem ent of urethral electrical conductance and leak point pressure. Imaging usi ng ultrasound, X-ray, magnetic resonance or isotopes is sometimes indicated . While neurophysiological resting has little clinical application, cystour ethroscopy is of value in various subgroups of women. Thorough assessment a nd appropriate investigation together result in an accurate diagnosis which in turn allows appropriate treatment for urinary incontinence to be initia ted.