SUI is short for 'stress urinary incontinence'. It is a condition in which a woman loses a few drops of urine when she coughs, sneezes, laughs loudly or in severe cases, suddenly gets up from a lying down position. Victor Bonney described an ingenious test to diagnose it clinically, now popularly known as Bonney's test. In this test the woman in a dorsal examination position is asked to cough. If she loses a few drops of urine, the bladder neck area is elevated above the urogenital diaphragm by placing tips of index and middle fingers on either side of the urethrovesical junction. Then she is asked to cough again. If there is no loss of urine, the test is positive and the woman had SUI.
I have been performing Bonny's test for years. In the last few days something funny has been happening. There was a stout woman with symptoms suggestive of SUI. It is prudent to stand well away from the expected path of the urine that spurts out on coughing. I stood well away, and that too well on the right side rather than in front of her. When I asked her to cough, she coughed. The urine spurted out, but instead of remaining in the midline, it spurted to extreme right, exactly on my forearm, hand, and sleeve of my apron. I completed the test, washed away the urine and went to change my apron. A week later, there was another woman, of similar size and complaint. I was more cautious than the last time. I hid myself behind her leg and stayed as much to the right as was possible. When she coughed, her urine spurted more to the right than the last time. It soaked my forearm and hand, but spared my apron. I completed the test and washed away the urine. The third week, I decided that there was something wrong with the examination table and that caused a deviation of the stream of urine to the right. So I stood on the left side this time, well behind her left leg. When she coughed, the urine spurted to the left, on my left forearm, hand, and apron sleeve. I washed away the urine and changed my apron. But I could not get rid of a feeling that someone had put a jinx on that table. That jinx, which can be called the 'jinx of SUI', seemd to make the urine spurt on the examining hand, whether it was in midline, on the right or on the left. When I told my wife about this, she said with an amused look on her face,
"So what will you do now?"
"I have a plan to see what it exactly is" I said. "I plan to ask other clinicians if they have experienced this when examining patients on that table. If not, I will examine the next patient and then ask a colleague to examine her standing in the same position. If the urine spurts on both of us, the table is jinxed. If it spurts on my hand but not on my colleague's, someone has jinxed me."
"What if it spurts on your colleague's hand and not on yours?" she asked with the same amused look.
"Then one can say the jinx got confused or shifted from me to my colleague" I said.
She looked hard at my face and said nothing.
"Just kidding" I said.
I have been performing Bonny's test for years. In the last few days something funny has been happening. There was a stout woman with symptoms suggestive of SUI. It is prudent to stand well away from the expected path of the urine that spurts out on coughing. I stood well away, and that too well on the right side rather than in front of her. When I asked her to cough, she coughed. The urine spurted out, but instead of remaining in the midline, it spurted to extreme right, exactly on my forearm, hand, and sleeve of my apron. I completed the test, washed away the urine and went to change my apron. A week later, there was another woman, of similar size and complaint. I was more cautious than the last time. I hid myself behind her leg and stayed as much to the right as was possible. When she coughed, her urine spurted more to the right than the last time. It soaked my forearm and hand, but spared my apron. I completed the test and washed away the urine. The third week, I decided that there was something wrong with the examination table and that caused a deviation of the stream of urine to the right. So I stood on the left side this time, well behind her left leg. When she coughed, the urine spurted to the left, on my left forearm, hand, and apron sleeve. I washed away the urine and changed my apron. But I could not get rid of a feeling that someone had put a jinx on that table. That jinx, which can be called the 'jinx of SUI', seemd to make the urine spurt on the examining hand, whether it was in midline, on the right or on the left. When I told my wife about this, she said with an amused look on her face,
"So what will you do now?"
"I have a plan to see what it exactly is" I said. "I plan to ask other clinicians if they have experienced this when examining patients on that table. If not, I will examine the next patient and then ask a colleague to examine her standing in the same position. If the urine spurts on both of us, the table is jinxed. If it spurts on my hand but not on my colleague's, someone has jinxed me."
"What if it spurts on your colleague's hand and not on yours?" she asked with the same amused look.
"Then one can say the jinx got confused or shifted from me to my colleague" I said.
She looked hard at my face and said nothing.
"Just kidding" I said.
