Practice bulletin on the diagnosis of female stress urinary incontinence in France from the Committee of Female Urology (CUROPF) of the French Association of Urology (AFU)

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.

Published by The French journal of urology, 2025. The guideline itself is at the source linked here.

doi.org/10.1016/j.fjurol.2025.102956