Aims of study
Pelvic floor reeducation programs often involve biofeedback-methods to increase pelvic floor awareness, tone and contraction [1]. It was the purpose of this study to introduce functional video-urethrocytoscopy as a new method of visual biofeedback and to compare immediate responses to three different biofeedback-methods during routine urogynaecological assessment.

Patients and method
Up to now thirty-five consecutive urinary incontinent women attending our urogynaecology clinic were asked which of the following three biofeedback-methods they found most beneficial regarding understanding of pelvic floor anatomy and function.

1. Perineal ultrasound: visualisation of bladder neck at rest, Valsalva, contraction and coughing
2. Video-urethroscystoscopy: visualisation of bladder neck at rest, contraction and coughing
3. Digital assessment of pelvic floor tone and strength of contraction: sensory awareness and verbal feedback

The order of biofeedback-methods was randomised to avoid operant conditioning bias. The women completed the questionnaire after the examination in which the follwing question were obtained: Which is the prefered method to gain awereness in:
§ Anatomic location of the pelvic floor muscle (PFM) ?
§ Functional understanding of the PFM to urethral closure ?
§ Understanding the aims of physiotherapy ?

Results
The mean age was 55 years (24-86). Twenty-one women complained of stress incontinence, seven of urge incontinence and seven had mixed symptoms. Thirty-seven percent of women found that the awareness of the pelvic floor muscle was best accomplished by cystoscopy. Table 1 shows the patients preference of biofeedback-methods with respect to understanding of anatomy and function of pelvic floor muscle and its value for preparation of pelvic floor exercises. Table 1: The women's preferences.

Conclusion
Visual biofeedback-methods like cystoscopy and perineal ultrasound seem to be superior to digital feedback. Video-urethroscopy is an effective method to teach function of the pelvic floor this increase the spectrum of indications of urethrocystoscopy in female urinary incontinence. Reference 1) BJU Int 1999; 83: 1015-1016.