• Richard F. Labasky


Accurate diagnosis of a woman’s incontinence and prolapse is essential to guide treatment decisions, and because these problems may merely be indicators of more serious processes such as neoplasm, obstruction, or neurological diseases.1The evaluation process should lead to accurate diagnoses, and use appropriate diagnostic tests, while avoiding unnecessary ones. The evaluation should also provide an understanding of the patient’s health and personal status to facilitate wise counseling about what treatments will be successful and safe for her. The evaluation includes noting details of the patient’ssymptoms of incontinence and prolapse, confirming thesigns of urinary loss and prolapse, and possibly performing tests to isolate specifically the pathophysiological causes of the conditions.2-4 The basic evaluation with all three steps — history, examination, basic tests, and an optional simple “bedside CMG” (see later) — leads to accurate dianoses that correlate with the patient’s problems of incontinence and prolapse in about 80% of patients, especially for those with stress incontinence.5-12 If the basic evaluation fails to provide an adequate diagnosis, imaging studies, cystourethroscopy, and formal urodynamics — detailed neurophysiologic tests of the lower urinary tract — are used to confirm diagnoses. To be considered accurate and useful, it is essential that the final diagnoses correlate with the patient’s primary complaints and symptoms.


Urinary Incontinence Pelvic Floor Anal Canal Stress Incontinence External Anal Sphincter 
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  • Richard F. Labasky

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