Valsalva urethral profile (VUP): A urodynamic measure to assess stress urinary incontinence in women

Abstract

Aims We aimed to assess the value of the Valsalva urethral profile (VUP) in case of stress urinary incontinence (SUI). Methods Six hundred and ninety‐four women without pelvic organ prolapse were included in this prospective monocentric study. SUI was diagnosed from symptoms using the International Continence Society definition, and severity using two validated questionnaires (USP and ICIQ‐SF). The urodynamic parameters studied were maximal urethral closure pressure (MUCP) and functional length (FL). Both were performed at rest, during a Valsalva maneuver (v‐MUCP and v‐FL) and again at rest. Correlation analyses and ROC curves were used to assess the value of the clinical and urodynamic measurements. Results In our population, based on the questionnaires, 172 (24.8%) women were diagnosed with pure SUI on symptoms, 71 (10.2%) with urgency urinary incontinence and 392 (56.5%) with mixed urinary incontinence; 59 (8.5%) women were continent. The v‐MUCP was the most correlated parameter to the severity of SUI (ρ: −0.63) and the most predictive of SUI risk, with a threshold value of 35 cm H2O (Se = 0.82, Sp = 0.86). The v‐FL was significantly shortened in case of SUI. Conclusions The v‐MUCP and v‐FL are global measurements of urethral resistance during stress. With a threshold value of 35 cm H2O, the v‐MUCP was the most discriminating parameter for the diagnosis of SUI, with a good reliability.

Urinary Incontinence in Competitive Women Weightlifters

“…Although it seems that lifting a heavy weight, especially multiple times, may provoke UI, it is less clear if long-term heavy lifting damages the pelvic floor. The concern that lifting heavy weights may damage the pelvic floor and increase the risk of UI comes from 3 main bodies of research which examined the effects of heavy physical work (24), increases in intra-abdominal pressure when lifting a weight (10), and the effect of increases in intraabdominal pressure on the urethra (9,17). Repeated high-impact activities are likely to further contribute to fatigue of the pelvic floor and increase the odds of UI (27,30).…”