Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence

Theofrastous, James P.; Bump, Richard C.; Elser, Denise M.; Wyman, Jean F.; McClish, Donna K.

doi:10.1016/0002-9378(95)90260-0

Cited by 73 publications

(57 citation statements)

References 12 publications

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“…When we look at the specifi c condition of stress incontinence, resting MUCP value is known to tend to be lower than in continent women and decreases as a function of age (11)(12)(13)(14)(15)(16), but there is no absolute cut-off value with suffi cient sensitivity and specifi city for that diagnosis and the association between MUCP and the severity of incontinence (1,21,22). In our population, MUCP values at rest (P1) tend to be lower in stress incontinent women except in the middle age group where women with mixed incontinence (which however implies a stress component) have lower MUCP.…”

Section: Discussionmentioning

confidence: 99%

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

2012

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Introduction: Our purpose was, applying a strictly defi ned protocol for urethral profi lometry, 1) to test the repeatability of same session rest maximum urethral closure pressure (MUCP) and 2) to search for correlation between women complaint and the changes in MUCP value (rest and dynamic tests). Materials and Methods:A population of 140 consecutive women referred for evaluation of lower urinary tract dysfunction was stratifi ed in 4 groups according with the urinary symptoms: stress, urge, mixed incontinence and continent and in each group in 3 age groups (young, middle age and old). The sequence of tests recorded in supine position was: urethral pressure profi le at rest bladder empty, after bladder fi lling at 250 mL (reference test), stress profi le, fatigability (before (rest) and after 10 successive strong coughs), then in standing position. Results: In all groups, there was no signifi cant difference between the two MUCP values at rest bladder fi lled. In the three incontinent groups, MUCP was higher bladder empty than bladder fi lled (p < 0.05) except in the young sub-group. Stress incontinence led to signifi cant decrease of MUCP during dynamic tests in the young group. MUCP was not modifi ed after fatigability test in women with urge complaint whatever age. Conclusion: When recorded following a strictly defi ned protocol, MUCP at rest bladder fi lled has a good repeatability in individual. However a complex sequence of tests during urethral pressure profi lometry remains discussed in middle-age and old age--groups, it allows specifying the stress component of incontinence in young women and the urgency component in all age-groups. INTRODUCTIONControversies about the role of urethral pressure profi lometry (UPP) in clinical practice (1-3) are mainly based on the reproducibility of the measurements and on the lack of standardization (4).Other main controversies are related to the predictive value of the preoperative maximum urethral closure pressure (MUCP) and the success of the surgery of stress incontinence (5-9) and the postoperative quality of life (10). Conversely, De Lancey (11) found that MUCP was the most characteristic parameter of stress incontinence.In our urodynamic laboratory, we have defi ned a strict protocol for UPP which is routinely applied in order to rule out many causes of variability. It consists of a well-defi ned sequence Vol. 38 (6): 809-817, November -December, 2012 Is a sequence of tests during urethral pressure profi lometry correlated with symptoms assessment in women? ___ _______________________________________________ ____________________________________________

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Section: Discussionmentioning

confidence: 99%

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

2012

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“…This view is not necessarily shared by all specialties in the urodynamic community. LPP values within low ranges suggest more severe incontinence and LPP values in higher ranges suggest less severe incontinence [Theofrastous et al, 1995]. Data about LPP are con£icting since it is likely that this measure assesses only one of the factors of incontinence.…”

Section: Discussionmentioning

confidence: 99%

Relationship of urethral retro‐resistance pressure to urodynamic measurements and incontinence severity

Slack

Culligan

Tracey³

et al. 2004

Neurourology and Urodynamics

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The study demonstrated that URP had a consistent relationship with incontinence severity. The data suggested that URP is a physiological measure of urethral function and may have clinical utility as a diagnostic tool. Future outcomes-based research is necessary to establish the predictive value of URP, MUCP, and LPP measurements in terms of incontinence cure rates and diagnosis of sphincter dysfunction.

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“…The abdominal leak point pressure (ALPP) is the urodynamic parameter typically used to assess the presence and magnitude of sphincteric dysfunction [Cespedes and McGuire, 1998]. While the ALPP appears to correlate with objective incontinence severity in women with stress incontinence [Theofrastous et al, 1995;Bump et al, 1997], there are few studies correlating the ALPP to objective severity of incontinence in post-prostatectomy patients. The objective of this study was to determine if the ALPP correlates with the objective severity of incontinence, as assessed by the 24-hr pad test, in patients su¡ering from post-prostatectomy stress incontinence.…”

Section: Introductionmentioning

confidence: 99%

Correlation of abdominal leak point pressure with objective incontinence severity in men with post‐radical prostatectomy stress incontinence

Twiss

Fleischmann

Νitti

2005

Neurourology and Urodynamics

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ALPP did not correlate significantly with the 24-hr pad test in patients with post-prostatectomy stress incontinence. This suggests that in this patient subset, the ALPP is a relatively poor predictor of incontinence severity and, therefore, has limited clinical value in the urodynamic evaluation of post-prostatectomy incontinence. The urodynamic assessment of these patients should focus on the presence or absence of stress incontinence and on the presence of associated bladder dysfunction.

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Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence

Cited by 73 publications

References 12 publications

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

Relationship of urethral retro‐resistance pressure to urodynamic measurements and incontinence severity

Correlation of abdominal leak point pressure with objective incontinence severity in men with post‐radical prostatectomy stress incontinence

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