ABSTRACT
I. INTRODUCTION Physical examination of the patient, together with a detailed clinical history, and whenever possible, the voiding diary, are the three cornerstones on which any further evaluation, diagnosis, and therapeutic plan are built. Except for neurourological examination, there are presently no scientific data documenting the parameters of a normal pelvic examination (especially in the female) and, consequently, the components of the examination have not been universally agreed on (1). Furthermore, we often assume that findings on physical examination correlate with lower urinary tract function. This is not necessarily true: For example, no specific physical sign can be found in patients with unstable bladders, even when sophisticated neurological examinations are performed (2). Also, in a recent analysis of 221 female patients, no urethral hypermobility was demonstrated on vaginal examination, yet 122 (55%) claimed urinary stress incontinence in their clinical history. On the other hand, 90% of 233 patients with grade II cystourethrocele reported clinically significant stress urinary incontinence on a questionnaire (3), yet 10% of these patients claimed perfect continence during physical stress (Table 1). These observations by no means imply that physical examination should be neglected but, rather, it should be put in its proper perspective.
