Infla10® Pulse™Also Known As
Cough stress test, bladder stress test, provocative stress test, urinary stress test, Bonney test (modified version), supine empty stress test (SEST), standing stress test
Definition
A stress test is a clinical diagnostic procedure used to demonstrate urinary incontinence by simulating conditions that increase intra-abdominal pressure.1 During this test, a healthcare professional observes for involuntary urine leakage when the patient performs activities that put pressure on the bladder, such as coughing, sneezing, or bearing down with a full bladder.2 The test is primarily used to diagnose stress urinary incontinence (SUI), a condition characterized by the sudden, involuntary leakage of urine during activities that increase intra-abdominal pressure.3 The stress test is considered a fundamental component of the basic evaluation of patients with symptoms of urinary incontinence and helps differentiate between various types of incontinence, particularly stress and urge incontinence.4 This non-invasive test provides objective evidence of stress urinary incontinence and helps guide appropriate treatment decisions.5
Clinical Context
The stress test is a key component in the clinical evaluation of patients presenting with symptoms of urinary incontinence.1 It is particularly valuable in diagnosing stress urinary incontinence, which affects approximately one-third of adult women.2 The test is indicated when patients report involuntary urine leakage during activities such as coughing, laughing, sneezing, or physical exertion.3
According to clinical guidelines, the minimum evaluation before considering surgical treatment for stress urinary incontinence should include a stress test along with medical history, urinalysis, physical examination, assessment of urethral mobility, and measurement of postvoid residual urine volume.4 The test is typically performed with the patient having a comfortably full bladder in both supine and standing positions.5
The procedure involves asking the patient to cough forcefully or perform a Valsalva maneuver while the healthcare provider observes for urine leakage from the urethra.2 A positive test, indicated by visible urine leakage coinciding with the increase in abdominal pressure, confirms the diagnosis of stress urinary incontinence.3 The test may be modified (Bonney test) by supporting the bladder neck to assess whether surgical correction might be beneficial.5
For patients with positive stress tests, treatment options range from conservative approaches (pelvic floor muscle training, lifestyle modifications) to surgical interventions depending on severity and patient preference.1 Evidence suggests that in uncomplicated cases with positive stress tests, additional urodynamic testing may not significantly improve treatment outcomes.4