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

Article Abstract:

The severity of urinary stress incontinence may potentially be evaluated by Valsalva leak point pressure determinations. Stress incontinence occurs when abdominal pressure on the bladder exceeds the ability of the urethral sphincter to remain closed. Seventy-five women with stress incontinence had a Valsalva maneuver test and passive and dynamic urethral pressure profiles. In the Valsalva leak point pressure test, women hold their breath and bear down. The urethral pressure at which leakage occurs is determined. Incontinence severity was evaluated by the number of incontinence episodes and pads used weekly, measurements of the amount of fluid lost, and scores on a quality-of-life evaluation. The Valsalva leak point pressure was correlated with severity of incontinence as was the passive urethral pressure profile. No significant correlations were found with dynamic urethral pressure profiles. Only the Valsalva maneuver test correlated with amount of fluid lost. The Valsalva leak point pressure test requires less equipment so is potentially cheaper to perform.

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Valsalva leak point pressures in women with genuine stress incontinence: reproducibility, effect of catheter caliber, and correlations with other measures of urethral resistance

Article Abstract:

The technique of measuring Valsalva leak point pressures needs to be standardized before it is used as a means of evaluating stress incontinence in women. This test measures pressure within the bladder at the point at which bearing down or coughing produces leakage at the urethral opening. Sixty women with known stress incontinence underwent Valsalva leak point pressure evaluations with two different sized catheters to measure pressure. All but one woman leaked urine with at least one of the four measurements. However, the pressure at which leakage occurred varied between catheter sizes, and while larger catheters usually increased the pressure at which leakage occurred, this was not always true. Higher pressures were also required for coughing than steadily bearing down, probably because there is a protective reflex with a cough.

Testing

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The urethrodetrusor facilitative reflex in women: results of urethral perfusion studies

Article Abstract:

Urethral perfusion may be able to identify women with mixed incontinence. Mixed incontinence occurs when a woman has genuine stress incontinence and detrusor instability. In a study of 63 women, 57% of those with mixed incontinence experienced detrusor contraction during urethral perfusion compared to 10% of those without mixed incontinence.

Urinary incontinence

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