A 38 yo female presents with urinary incontinence. During the exam, she leaks urine with laughing. Her pelvis exam is normal except a swab test showing a 40-degree change. Urinalysis is normal. No significant medical or surgical history. What is the minimal diagnostic evaluation needed before going to surgery?
No additional steps required
Evaluation of a patient with urinary incontinence should include an objective demonstration of urinary incontinence and a postvoid residual
ACOG recommends using a swab test to assess urethral mobility (hypermobility is defined as greater than 30 degrees)
Cystoscopy can be performed for concerning symptoms like hematuria, recurrent infections
Urodynamics do not offer added benefit in uncomplicated patients with incontinence. They can be used to diagnose intrinsic sphincter deficiency which is better treated by retropubic sling, but this patient does not have risk factors (smoking, hypoestrogen, prior urologic surgery)