The presence of transurethral cystometry catheter and type of stress test affect the measurement of abdominal leak point pressure (ALPP) in women with stress urinary incontinence (SUI)

Abstract

Cough-induced stress test is significantly more sensitive than Valsalva to demonstrate urinary leakage. Cystometry catheter significantly increases cough and Valsalva ALPP whereas stress test can be false negative due obstructive effect of cystometry catheter in a group of patients. Stress test may be negative in the semi-supine position in about 14% of women complaining of SUI.

Can preoperative urodynamic investigation be omitted in women with stress urinary incontinence? A non‐inferiority randomized controlled trial

“…One of the inclusion criteria was observed incontinence on physical examination and/or micturition diary, but still urodynamic SUI was absent in almost half of cases. In other reports urodynamic SUI could not be demonstrated in 16–29% 28–30. A falls negative stress test during urodynamics could be caused by obstruction of the urethra by the transurethral catheter 30.…”

“…In other reports urodynamic SUI could not be demonstrated in 16-29%. [28][29][30] A falls negative stress test during urodynamics could be caused by obstruction of the urethra by the transurethral catheter. 30 The obstructive effect of a maximum diameter of 8 French catheter was considered as acceptable.…”

“…[28][29][30] A falls negative stress test during urodynamics could be caused by obstruction of the urethra by the transurethral catheter. 30 The obstructive effect of a maximum diameter of 8 French catheter was considered as acceptable. 31 In our studies, the maximum catheter size was 7 French, therefore, the low prevalence of urodynamic SUI compared with other studies could not be explained by catheter size.…”

ICS Educational Module: Cough stress test in the evaluation of female urinary incontinence: Introducing the ICS‐Uniform Cough Stress Test

“…In the supine position (using pads to measure the leakage), it was noted that only 49% of women leaked during the cough stress test (when floor and trampoline jumping were used as the comparator) . In addition, CST was negative when done in a semi‐supine position in 14% of patients who complain of SUI in another study on the effects of a UDS catheter on the diagnosis of SUI . Furthermore, it has been noted that during LPP testing (done during CMG with a catheter in place), both Valsalva LPP and CLPP are significantly lower when the patient is standing versus supine …”

Valsalva leak point pressure-associated Q-tip angle and simple female stress urinary incontinence symptoms

“…If urine leakage was not observed with the Valsalva maneuver, the patient was asked to cough. On the basis of the VLPP results, the patients were classified into 1 of 2 groups [17]: (1) …”