Predictive value of clinical evaluation of stress urinary incontinence: A summary of the published literature

Our objective was to evaluate the symptom and sign of stress incontinence i n predicting the presence of urodynamically diagnosed genuine stress incont inence (GSI). The study was a computation of the sensitivity and predictive values from the published literature (1975-1998), evaluating the history a nd/or physical examination for the diagnosis of GSI, with calculation of ef ficacy variables. Results show that the isolated symptom of stress incontin ence has a positive predictive value (PPV) of 56% for the diagnosis of pure GSI and 79% for GSI with additional abnormalities. The PPV of stress incon tinence in association with other symptoms is 77% in detecting GSI (with or without additional abnormalities). A positive cough stress test has a PPV of 55% for detecting pure GSI and 91% for the mixed condition (GSI plus add itional diagnosis). When isolated, the symptom or the sign of stress incont inence is a poor predictor of GSI. In combination, the prediction may be mo re promising.