The diagnosis of female urinary incontinence is clinical. CLINICAL INTERVIEW: It must be precise and guided. It allows subjective assessment of the patient's history, triggering factors, volume of urine leakage. It is recommended to classify the type of urinary incontinence: stress. urge or mixed urinary incontinence. Other voiding disorders must be noted: dysuria, frequency, pain. These disorders can be recorded on a voiding diary kept for at least 2 days. which is recommended in the investigation of female urinary incontinence. The clinical interview also looks for any associated anorectal disorders (anal incontinence and altered bowel habit).
Clinical examination: The full bladder examination and the cough test to confirm urine leakage and correction of the leakage by bladder neck support (Bonney test) and urethral support are recommended in the investigation of female urinary incontinence, The Q-tip test is not recommended to measure urethral hypermobility. A pad-test is not recommended in the evaluation of documented stress incontinence, but is recommended to confirm urinary incontinence not diagnosed clinically or in clinical trials evaluating a treatment for urinary incontinence. A Valsalva manoeuvre to detect associated prolapse and perineal muscle testing are recommended as part of the clinical examination of all cases of incontinence. In the case of prolapse associated with urinary incontinence, the Baden-Walker classification or the Pop-Q classification proposed by the ICS (International Continence Society) should be used. The ICS classification has the advantage of being objective and reproducible, but is complicated and may be reserved for clinical trials. In routine clinical practice, the 4-stage Baden-Walker classification is sufficient.