What investigations are needed to diagnose stress urinary incontinence?
A proper history of incontinence episodes and past obstetric history and a detailed examination is enough to clinch the diagnosis. It is important to note the degree of genitourinary prolapse, document urethral descent by Q-tip test, ascertain tone of pelvic muscles and prove incontinence by Bonney Marshall test. It is therefore important to do a pelvic exam on full bladder.
In patients with mixed incontinence, it becomes mandatory to perform a urodynamic assessment to rule out overactive bladder before considering surgery. Urine analysis and urine culture should always precede specialized tests for other causes of urgency. Imaging studies alone give little information but can be of great help when combined with urodynamics as they tell the exact pathophysiology of stress incontinence.