Jinekoloji ve Obstetri Bulteni, vol.6, no.1, pp.26-32, 1997 (Scopus)
Urinary incontinence, which is defined by the International Continence Society as 'a condition in which involuntary loss of urine is a social and/or a hygienic problem and is objectively demonstrable', is observed approximately in 25% of the women. It is known that urinary incontinence is caused by urethral sphincteric incompetence (anatomic stress incontinence) and/or involuntary detrusor contraction (detrusor instability) in more than 95% of the patients. Detrusor instability is a clinical condition, characterized by involuntary and uninhibited contractions which evolves spontaneously or by provocation in the storage phase of the patients who have no neurologic problem. Anatomic stress incontinence is a urinary leakage, which occurs when intravesical pressure exceeds the maximal urethral pressure during stress, without having any detrusor contractions. Patients must be completely evaluated urogynecologically, as differential diagnosis of the type of incontinences which have entirely different pathophysiology and treatment methods is very important. Using a stepped urogynecologic evaluating protocol acquires the correct diagnosis in a short and cheap way, by preventing unnecessary tests. It is possible to diagnose the type of the incontinence and perform the appropriate treatment by this protocol in 85-90% of the patients, without using complicated urodynamic tests.