Bonney's test is used to confirm

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Bonney's test is a specific clinical maneuver designed to diagnose stress urinary incontinence (SUI).
SUI is primarily an anatomical problem caused by the hypermobility of the urethra and inadequate support of the bladder neck.
The test works by manually elevating the bladder neck. If this support prevents urine leakage during a stress event like coughing, it confirms that the incontinence is due to this anatomical defect.
A positive Bonney's test indicates that surgical procedures aimed at restoring support to the bladder neck are likely to be successful.

Option B: Urge incontinence is caused by involuntary contractions of the bladder's detrusor muscle. Bonney's test, which provides anatomical support, does not address this muscular overactivity.
Option C: Overflow incontinence is due to an overdistended bladder that cannot empty properly, leading to dribbling. The test does not evaluate bladder emptying or obstruction.
Option D: Neurogenic incontinence results from nerve damage affecting bladder control. Its diagnosis requires a comprehensive neurological evaluation and urodynamic studies to understand the specific type of nerve dysfunction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic evaluation of urinary incontinence as background academic context rather than a clinical decision trigger.
Accurately diagnosing the type of urinary incontinence is crucial for selecting the appropriate treatment, as management differs significantly (e.g., pelvic floor exercises for stress vs. anticholinergic medications for urge).
A positive Bonney's test can help predict the success of surgical procedures like retropubic suspension or slings, which aim to restore bladder neck support.
What if? If a patient leaks urine with coughing but the leakage is NOT stopped by Bonney's test, it may suggest intrinsic sphincter deficiency (ISD), a more severe form of stress incontinence where the urethral sphincter itself is weak. This would require different surgical considerations.

How to Approach the Question

First, identify the key term in the question stem, which is 'Bonney's test'.
Recall the purpose and procedure of this clinical test. It is a physical maneuver performed during a pelvic exam.
Consider the mechanism of the test: it involves manually supporting the bladder neck to see if it stops urine leakage.
Analyze the pathophysiology of each option. Stress incontinence is anatomical (lack of support), while urge, overflow, and neurogenic incontinence have different causes (muscular, obstructive, neurological).
Match the test's mechanism (providing anatomical support) with the corresponding condition (stress incontinence).

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 112-114

E6 Gynecology Williams p. 108-133