The role of imaging in urinary incontinence

A detailed history, physical examination, symptom and quality-of-life assessment, and urine analysis are unanimously considered essential components of the initial evaluation of urinary incontinence. Beyond these assessments, there are no universally accepted recommendations and, to date, imaging is not recommended in the initial management of urinary incontinence. In selected patients, urodynamics and/or a radiographic evaluation may be indicated. According to International Continence Society guidelines, imaging of the upper and lower urinary tract is indicated only if renal damage or pelvic pathology are suspected; video-urodynamics and voiding cysto-urethrography are considered optional diagnostic tests and continue to be refined; magnetic resonance imaging is considered an important research tool in evaluating lower urinary tract disorders, but at present its clinical role remains investigational.