Patient characteristics that are associated with urodynamically diagnosed detrusor instability and genuine stress incontinence

Objective: We sought to compare characteristics of patients with urodynamically diagnosed detrusor instability or genuine stress incontinence. Study Design: A retrospective audit of 293 consecutive women who were referred to a urogynecologist for evaluation of urinary incontinence between June 1996 and April 2000. Results: Of the 293 patients, 289 women had a physical examination and urodynamic testing, which revealed genuine stress incontinence (35%), detrusor instability (32%), mixed incontinence (29%), or normal urodynamic function (4%). Compared with patients with detrusor instability, those women with genuine stress incontinence were more likely to be white than African American (P < .0001) and to have a cystocele(P = .027), rectocele (P < .0001), or paravaginal defect (P = .004). No differences in age, gravidity, parity, estrogen treatment, or previous anti-incontinence procedure were identified between women with detrusor instability and women with genuine stress incontinence. Conclusion: In a tertiary referral center, the distribution of urinary incontinence is evenly divided among genuine stress incontinence, detrusor instability, and mixed incontinence. Patients with genuine stress incontinence are more likely to be white and to have pelvic floor prolapse and symptoms of pure stress incontinence. (Am J Obstet Gynecol 2002;186:866-8.)