PURPOSE: This study was conducted to investigate whether predictive factors are associated with stress urinary incontinence due to intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: We reviewed retrospectively the records of 254 women with the diagnosis of genuine stress incontinence. All women had undergone a detailed history by questionnaire and interview, physical examination and multi-channel urodynamic study, including the determination of VLPP. The patients were classified into three groups according to VLPP regardless of the presence of hypermobility; 1) ISD: VLPP<60cmH2O, 2) equivocal: VLPP 61-90cmH2O, 3) anatomical incontinence(AI) : VLPP>90cmH2O. The ISD group was compared with the AI group using 15 clinical factors. Univariate (t-test, chi-square test) and multivariate (logistic regression test) analyses were performed to determine which clinical factors were associated with ISD. RESULTS: The mean patient age was 51 years (range 25 to 77). Eighty-two women (32%) were in the ISD group and 98 (38%) in the AI group. The results of univariate and multivariate analyses found that women with ISD had a higher symptom grade than women with AI (p=0.001 and 0.0001, respectively). The number of patients in the ISD and AI group in accordance with the symptom grade were 11 (15%) and 61 (85%) in grade I, 53 (62%) and 33 (38%) in grade II, and 18 (82 %) and 4 (18%) in grade III respectively. There was no correlation between VLPP and other clinical factors. CONCLUSIONS: The only clinical factor that predicted the presence of ISD, as defined by VLPP of 60cmH2O or less, was the symptom grade. Higher grades of stress urinary incontinence have a higher possibility of ISD. One should consider this factor when evaluating patients, especially in the equivocal group.