Referral patterns and diagnoses in women attending a urodynamic unit.

Patients, methods, and results We reviewed the urodynamic diagnoses of 2845 women seen over 10 years (1981-90). The review included all patients with symptoms of urinary incontinence who were neurologically intact and had no history of surgery for incontinence. All patients were examined by filling and voiding cystometry, and the urodynamic diagnosis assigned to each patient was based on International Continence Society definitions.2 The number of patients referred in each age group and their urodynamic diagnoses are shown in the table. Review of the referral pattern indicates that the peak age was in the perimenopausal years, 1548 (54%) of the patients being in the 36-55 year age range. The most striking feature was the small number of patients attending in the older age groups, only 395 (14%) patients being over the age of 66. That age group has a reported prevalence of incontinence of 11 -6%.' The trend in urodynamic diagnosis showed that genuine stress incontinence was the most common diagnosis overall, being found in 1774 (62%) of the patients. These included patients with pure genuine stress incontinence and those with mixed incontinence. The percentage with genuine stress incontinence increased steadily into the perimenopausal years and thereafter remained relatively constant. There was a gradual increase in detrusor instability with age, ranging from 16% in the 16-25 age group to 45% in the