Urodynamic investigation consists of evaluation of detrusor stretch responses, muscle strength and motor activities. The electrosensitivity test is the only method to evaluate mucosal sensory threshold of exteroceptive receptors in urinary bladder and posterior urethra thus checking integrity of sensory reflex arcs. A constant current square wave pulse of 0.5 msec duration and 10 msec interval is used with increasing amplitude from 0 to 25 mA until the patient registers sensation. Skin electrosensitivity is tested to start with, then perception threshold of urinary bladder and posterior urethra is recorded. Sensory deficits after segmental sacral nerve lesions or after peripheral nerve injuries postoperatively can be quantitated in terms of milliamperes. The urgency syndrome in adult women is characterized by a low perception threshold in the posterior urethra (below 1 mA) while the bladder electrosensitivity is within normal range (3–10 mA).

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It is shown that the site-frequency distribution of carcinomas relative to the upper and lower hemispheres of the urinary bladder is inhomogeneous. It is pointed out that the contact with urine is the important etiological factor and that other factors, if any, play only a secondary role. It is suggested that prolonged (forced) retention of urine should be avoided. Investigation of urinary carcinogens is needed.

On reviewing the literature most authors were found to have used needle electrodes for recording muscle potentials of pelvic floor muscles. We used for the first time a vaginal tampon electrode to record potentials of musculus levator ani in females and the same electrode to record potentials of the external anal sphincter. Recording with surface electrodes is especially recommendable for repetitive investigations for follow-up studies in outpatients and children. EMG patterns of pelvic floor muscles with vaginal tampon electrodes are comparable with those derived by needle electrode. EMG criteria of diagrams in upper motor neuron lesion, lower motor neuron lesion and with irritable bladders are discussed and explained.

30 stress incontinent women with none or mild-degree suspension defects were selected for conservative therapy with an alpha-adrenergic stimulant (midodrine), a chohnesterase inhibitor (distigmine bromide), a tricyclic antidepressant (imipramine) and estriol (Triodurin®). The effect of these drugs on the urethral pressure profile parameters such as maximum urethral pressure and the planimetric index of the continence area were compared with parameters before and after pubovaginal sling operation, before and after single drugs and drug combinations. The medication period in each case was 4 weeks. While the profile area of the continence zone increased after successful suspension surgery by 45%, the increase was 9% after midodrine, 8.9% after imipramine, 7.3% after estriol and 0.48% after distigmine bromide. The maximum urethral pressure showed an increase of the mean values by 8.1% after surgery, 8.3% after midodrine, 7.9% after imipramine, 3.5% after estriol and 3.5% after distigmine bromide. Subjectively, adjuvant therapy, i.e. estriol plus midodrine and estriol plus imipramine, was highly favored by the patients; the urodynamic assessment, however, failed to show significant advantages versus single drug therapy.