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

Abstract

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.

Urogynaecology: Urethral retro‐resistance pressure and urodynamic diagnoses in women with lower urinary tract symptoms

“…42 The URP decreases with increasing age and with years after the menopause, which are known risk factors associated with declining urethral function. 30 Although urodynamics remains the 'gold standard' test 43 in the assessment and management of women with LUTS, particularly prior to continence surgery to exclude DOA or voiding difficulties, the URP appears to be useful tool for the evaluation of urethral function at rest, but it is poor in its diagnostic discrimination. This test is useful for a scientific evaluation of the urethra as it measures different aspects of the urethral function at rest from the urethral pressure profile.…”

“…Following uroflowmetry, the post-micturition residual was measured using a transabdominal ultrasound scan. 33 The URP was then measured with woman relaxed in a supine position and an empty bladder by placing a 5-mm cone-shaped plug into the external urethral meatus as previously described by Slack et al 30 The device infused sterile fluid in a retrograde fashion through the urethra at a controlled rate of 1 mL/second (Monitorr, Gynecare, Ethichon, Somerville, New Jersey, USA). The pressure required to open the urethral sphincter is displayed on a screen and the URP measurement is recorded once the pressure stabilised as shown by a plateau on the screen.…”

“…A recent study in women with stress urinary incontinence demonstrated a significant correlation between URP and incontinence severity, suggesting that this parameter was a useful diagnostic tool to measure urethral function. 30 The reliability and reproducibility of the measurement have been demonstrated in asymptomatic women. 31 However, the role of URP in routine urodynamic practice is still unclear.…”

“…The URP is defined as the pressure required to achieve and maintain an open urethral sphincter at rest and is obtained by the infusion of sterile fluid along the urethra into the bladder. 30 The technique avoids catheterisation and may produce fewer artefacts and be less uncomfortable for the DOI: 10.1111/j.1471-0528.2005.00787.x www.blackwellpublishing.com/bjog Urogynaecology patient. However, the data on the usefulness of this test are limited.…”

Preoperative urethral parameters at rest and objective cure following laparoscopic colposuspension

“…Studies on urethral retroresistance pressure (the pressure required to achieve and maintain an open urethral sphincter) have demonstrated contradictory results regarding surgical outcome [12][13][14][15]. So urodynamics still have a substantial place when evaluating incontinent women prior to surgery [10,16].…”