Pelvic Floor Dysfunction
Recommended Reading
ARTICLE: Pelvic Organ Prolapse
Board Questions
A 52-year-old gravida 4 para 4 presents with bothersome incontinence, predominantly with coughing and straining. In addition to a physical examination, urinalysis, and measurement of postvoid residual volume, which one of the following tests is recommended as part of the initial evaluation?
A) Cough stress testing
B) Urodynamic testing
C) Pelvic ultrasonography with a vaginal probe
D) Cystoscopy
ANSWER: A
Cough stress testing helps detect urine leakage with coughing in patients with at least 200–300 cc of urine in the bladder or with the sensation of a full bladder. This test is recommended as part of the initial evaluation of women with symptoms of stress urinary incontinence. It has excellent sensitivity when compared to urodynamic testing. The initial evaluation could also include the cotton swab test (insertion of a lubricated swab into the urethra and evaluating angle change with the Valsalva maneuver). Urodynamic testing, pelvic ultrasonography, and cystoscopy are not recommended.
