Urinary incontinence is a sign of a disorder, not a diagnosis. Careful history and physical examination often suggest the correct diagnosis. However, complete accuracy can be obtained only by the judicious use of appropriate ancillary procedures including careful neurologic assessment and urodynamic evaluation of the bladder and urethra. The fact that the varieties of urinary incontinence occur infrequently poses a significant medical and legal problem. Unless the facilities for complete urologic evaluation are available and unless the surgeon by training and experience has demonstrated success in the treatment of urinary incontinence, most if not all of these patients should be considered for referral.