CLINICAL PREDICTORS OF URINARY-INCONTINENCE IN WOMEN

OBJECTIVE: Our purpose was to characterize historic and clinical param eters in incontinent women to determine the predictive value for urody namic diagnoses.STUDY DESIGN: The analysis includes 535 consecutive wo men with final diagnoses of genuine stress incontinence, detrusor inst ability, or both. Evaluations included a standardized history, examina tion, urinary diary, quantitation test, and urodynamics. The analysis used one-way analysis of variance, chi(2) analysis with Yates' correct ion, and Fisher's exact test. RESULTS: A total of 351 (66%) women were diagnosed with genuine stress incontinence, 102 (19%) with detrusor i nstability, and 82 (15%) with both. Half had symptoms of both stress i ncontinence and urge incontinence, of whom only 21% had both genuine s tress incontinence and detrusor instability. Fewer than half of women diagnosed with genuine stress incontinence or detrusor instability had just symptoms of stress incontinence or urge incontinence, respective ly. Evaluation of historic, examination, and urinary diary data for th eir influences on the predictive value of pure stress incontinence or urge incontinence revealed statistical differences for urethral hyperm obility, estrogen deficiency, and incontinent episodes, yet they were not clinically practical predictors. CONCLUSIONS: Pure symptoms identi fy fewer than half of patients with pure genuine stress incontinence o r detrusor instability; historic and clinical parameters do not improv e the sensitivity of these symptoms.