The gold standard investigation for urodynamic stress incontinence (USI) requiring surgical correction is:

• A Pad test (1-hour or 24-hour)
• B Cystoscopy under general anesthesia
• C Multichannel urodynamic study with concurrent videocystourethrography ✓
• D Ultrasound bladder neck mobility assessment

Explanation

Multichannel urodynamic study (cystometry with pressure-flow studies) is the gold standard for objectively diagnosing urodynamic stress incontinence before surgical intervention. Videocystourethrography adds anatomical visualization to functional data. NICE guidelines recommend urodynamic assessment before any surgical procedure for stress urinary incontinence to confirm the diagnosis, exclude detrusor overactivity, and assess bladder compliance. Pad tests quantify leakage but do not diagnose the mechanism. Ultrasound shows bladder neck mobility but is not sufficient for surgical planning.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.