Although the clinical history of urinary incontinence may be nonspecific, it is often valuable. Most patients with stress incontinence symptoms have true stress urinary incontinence, and many persons with symptoms of urgency or urge urinary incontinence have detrusor instability (12 - 15). Likewise, the physical examination may help identify the cause of urinary incontinence. The goals of physical examination also include identifying other medical conditions, such as reversible factors that may trigger or contribute to urinary incontinence, and assessing pelvic floor deficits that may warrant surgical correction. No studies were identified that directly assessed the utility of physical examination in the evaluation of urinary incontinence. However, several studies have identified reversible causes of urinary incontinence as a result of evaluations that included a physical examination. In one study evaluating the cause of urinary incontinence in 100 women referred to an incontinence clinic (mean age, 74.6 years), 17 patients had a urinary tract infection and 8 patients had fecal impaction, both of which are easily treatable causes of urinary incontinence (16). The fact that infection was identified in so many residents supports the importance of screening for symptoms of infection, such as a burning sensation. In a study of institutionalized and noninstitutionalized persons (mean age, 80.2 years) referred to an incontinence clinic for persistent urinary incontinence, 7 of 264 (3%) had reversible causes identified and successfully treated after a history, physical examination, and limited laboratory testing (17). Evaluation of reversible causes should screen for medications that can affect urine production or bladder or sphincter function (for example, diuretics, anticholinergic medications, opiates, and α-adrenergic medications).