Detection of urethral incompetence in women using the fluid-bridge test.

A new test for detecting urethral incompetence during coughing has been used in the investigation of women with urinary incontinence. The test detects fluid descending into the urethra and the results is positive a "fluid-bridge" is established between the bladder and a test point in the urethra. For the purpose of this study the test point selected was 0.5 cm from the urethrovesical junction. Sixty-seven incontinent patients and 23 women with normal urinary control were studied. Thirty-nine of the 67 incontinent women had a positive fluid-bridge test compared with only one of the women in the control group. The difference between the test results in the 2 group was highly significant (P < 0.001). In the incontinent patients a diagnosis was made after cystometry had been performed and after the urethral closure pressure profile had been measured. In 46 (69%) of these 67 patients there was agreement between the the diagnosis made following these urodynamic investigations and the one made from the new test. The advantages and shortcomings of the new method are compared with those of other stress tests in current use.