[Meta analysis of diagnostic methods in urinary stress incontinence]. / Metanálise dos métodos diagnósticos da incontinência urinária de esforço.

The analysis of existing diagnostic methods of urinary stress incontinence suggest that it is almost always clinical. Urodynamic evaluation has a place in special situations, as atypical symptom; neurologic disease; recurrent USI after surgery or when it is necessary to confirm the clinical diagnose.

Laparoscopy-assisted vaginal hysterectomy.

Intraoperative laparoscopy was used to evaluate pelvic pathology in 46 patients who had been anesthetized for abdominal hysterectomy. Because traditional indicators--clinical history, pelvic examination, and ultrasound studies--suggested the presence of more serious pelvic pathology, these patients were considered poor candidates for vaginal hysterectomy. Laparoscopic findings, however, revealed that 42 of the 46 (91%) could undergo uncomplicated vaginal surgery (which they did). Laparoscopy-assisted hysterectomy is recommended as an additional method of investigation in order to improve diagnostic accuracy and minimize surgical risk while allowing more frequent selection of the vaginal approach to hysterectomy.