Which of the following tests is used to assess stress incontinence?

Appeared in: DSSSB 12 August 2024

Explanation

Bonney's test, also known as the Marshall-Bonney test, is a physical examination technique used to diagnose stress urinary incontinence (SUI) caused by urethral hypermobility.
During the test, the examiner places two fingers into the vagina to elevate and support the bladder neck.
The patient is then asked to cough or perform a Valsalva maneuver, which increases intra-abdominal pressure.
If this manual support prevents the leakage of urine that otherwise occurs with coughing, the test is considered positive.
A positive result suggests that the incontinence is due to inadequate support of the urethra and bladder neck, and the patient may benefit from surgical procedures that provide this support.

Option B: The Bangle test is a screening tool for malnutrition, not a test for urinary incontinence.
Option C: Rothera's test is a biochemical test for detecting ketone bodies in the urine.
Option D: Benedict's test is a chemical test used to detect the presence of reducing sugars, such as glucose, in a sample.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic evaluation for stress urinary incontinence as background academic context rather than a clinical decision trigger.
Correctly diagnosing the type and cause of urinary incontinence is crucial for effective treatment planning. Bonney's test helps differentiate SUI due to urethral hypermobility from other causes.
A positive Bonney's test is a strong indicator that the patient will likely respond well to surgical interventions like a mid-urethral sling or bladder neck suspension, which are designed to restore support.
Nurses play a key role in preparing patients for these diagnostic tests, explaining the procedure, ensuring patient comfort and privacy, and documenting the findings accurately.

How to Approach the Question

Identify the core concept of the question, which is finding a specific diagnostic test for 'stress incontinence'.
Analyze each option provided. Recall or deduce the purpose of each test.
Recognize that Rothera's test and Benedict's test are well-known biochemical urine tests for ketones and sugar, respectively. Since stress incontinence is a mechanical/structural issue, these are unlikely to be correct.
Consider the Bangle test. Recall that this is a tool for assessing nutritional status (malnutrition) in children, which is unrelated to urinary function in adults.
By elimination, Bonney's test is the most plausible answer. Confirm this by recalling that it is a physical maneuver used in gynecology and urology to assess pelvic support structures related to incontinence.

Concept Tested & Keywords

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E6 Gynecology Williams p. 109-134

Practise the full DSSSB 12 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.