Can urodynamic stress incontinence be diagnosed by ultrasound?

Introduction and hypothesis Multichannel urodynamic testing is commonly used to diagnose urodynamic stress incontinence (USI). It has been claimed that USI may be diagnosed by imaging. In this study we determined the predictive value of ultrasound findings for USI. Methods This is an observational study utilising data obtained during urodynamic testing. Data sets were analysed in 209 patients in order to determine the predictive value of sonographic findings for the diagnosis of USI. Results Bladder neck descent and maximal urethral pressure were the only independent predictors of USI identified by multivariate logistic regression. The finding of a cystourethrocele with funnelling increased the odds of a diagnosis of USI by 2.5 (95 % confidence interval 1.17-5.4, p=0.018). Conclusions Translabial ultrasound can identify an anatomical configuration that is associated with USI. However, sonographic findings are insufficient to predict USI and can not replace urodynamic testing.