Stress urinary incontinence (SUI) is a common and burdensome condition among women, with a significant impact on daily functioning and quality of life. In France, evolving medico-legal and societal concerns, notably surrounding the use of synthetic midurethral slings, have led to major shifts in diagnostic and therapeutic practices. In this context, the Committee of Female Urology and Pelviperineology (CUROPF) of the French Association of Urology (AFU) has developed this practice bulletin to assist healthcare professionals in the diagnostic evaluation of female SUI. The bulletin adheres to current international definitions from the ICS and IUGA, distinguishing SUI from other forms of urinary incontinence. The document outlines a structured diagnostic pathway, including detailed patient interviews, standardized symptoms and quality of life questionnaires, and physical examination with emphasis on cough stress testing. It identifies key risk factors such as age, parity, mode of delivery, obesity, and menopausal status, while also reviewing more controversial factors like hysterectomy, radiotherapy, and constipation. The pathophysiological distinction between urethral hypermobility and intrinsic sphincter deficiency is presented as a central element for diagnostic orientation and subsequent treatment planning. Ancillary assessments such as voiding diaries, pad tests, and non-invasive urodynamic evaluations are discussed. Invasive urodynamics and imaging modalities are considered in selected, complex situations. This practice bulletin serves as a practical reference for clinicians facing diagnostic challenges in a transitional context, prior to the future publication of national guidelines. It aims to harmonize practices and improve care pathways for women with SUI.
The French journal of urology. 2025 Nov [Epub]
Benoit Peyronnet, Julia Klap, Caroline A Brandon, Pierre-Olivier Bosset, Sandrine Campagne-Loiseau, Jean-Nicolas Cornu, Laurence Donon, Lucie Even, Marie Florin, Frederic Girard, François Herve, Sophie Hurel, Francois Meyer, Caroline Plassais, Claire Richard, Thibault Thubert, Adrien Vidart, Rebecca Haddad, Caroline Thuillier
Department of Urology, University of Rennes, Rennes, France. Electronic address: ., Department of Urology, Hôpital Privé Claude-Galien, 91480 Quincy-sous-Senart, France., Department of Gynecology and Obstetrics, Paris-Saclay Hospital, 1, parvis de l'Hôpital, 91400 Orsay, France., Department of Urology, Hôpital Foch, 40, rue Worth, 92150 Suresnes, France., Department of Gynecology, University of Clermont-Ferrand, CHU of Estaing, Clermont-Ferrand, France., Department of Urology, Hôpital Charles-Nicolle, CHU Hôpitaux de Rouen, Rouen, France., Department of Urology, Private Hospital Côte Basque Sud, Bayonne, France., Department of Urology, Private Hospital Les Fleurs, La Seyne-sur-Mer, France., Department of Specialized Radiological and Interventional Imaging, Tenon Hospital, AP-HP, 75020 Paris, France., Department of Urology, Private Hospital Saint-Jean de Dieu, Paris, France., Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium., Department of Urology, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France., Department of Urology, Hôpital Saint-Louis, AP-HP, Paris, France; Department of Urology, Private Hospital Les Peupliers, Ramsay Group, Paris, France., Department of Urology, University of Rennes, Rennes, France., Department of Obstetrics and Gynaecology and Reproductive Medicine, Nantes University Hospital, Nantes, France., GRC 001 GREEN Neuro-Urology Research Group, Rothschild Academic Hospital, Sorbonne Université, AP-HP, Paris, France., Department of Urology, 14(e) Hôpital Michallon, University of Grenoble, CHU Grenoble-Alpes, boulevard de la Chantourne, 38700 La Tronche, France.