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More than 250,000 U.S. women undergo surgery for stress incontinence each year. Although urodynamic studies to measure parameters associated with bladder storage and emptying are often performed before surgical decision making, these tests are uncomfortable and expensive. At 11 U.S. centers, women who planned to undergo stress-incontinence surgery were randomized to standardized clinical evaluation alone or to such evaluation followed by urodynamic testing. Clinical evaluation for stress-incontinence surgery included a positive provocative stress test, normal postvoid residual volume, assessment of urethral motility, and exclusion of bladder infection. One year after surgery, treatment success — defined as ≥70% reduction in symptoms as meas…