Skip to main content
Top
Published in: International Urogynecology Journal 4/2012

01-04-2012 | Original Article

Detrusor overactivity leak point pressure in women with urgency incontinence

Authors: Ariana L. Smith, William I. Jaffe, Mary Wang, Alan J. Wein

Published in: International Urogynecology Journal | Issue 4/2012

Login to get access

Abstract

Introduction and hypothesis

When incontinence accompanies detrusor overactivity (DO), the pressure at which it occurs may have important predictive value and should be termed DO leak point pressure (DOLPP).

Methods

A retrospective review of our video urodynamics database (n = 222) including validated questionnaires was performed. DOLPP was defined as detrusor pressure the moment DO incontinence occurred. Statistical analysis was performed using Student’s t-test.

Results

Women with DO leakage (47) and with DO without leakage (15) were analyzed. Urgency and urgency incontinence (UUI) were greater among patients with DO leakage. A link between sphincter deficiency and greater severity of UUI was noted. Among patients with DO leakage, those with subjective mixed incontinence had a lower mean DOLPP than those with pure UUI (p = 0.004). The detrusor pressure at peak flow was lower in the DO leakage group (versus DO alone, p = 0.05) likely reflecting a measure of outlet resistance.

Conclusion

DOLPP has predictive meaning in women and should be further studied for possible inclusion in standard urodynamic terminology.
Literature
1.
go back to reference Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178PubMedCrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178PubMedCrossRef
2.
go back to reference McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 167(2):1049–1053CrossRef McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 167(2):1049–1053CrossRef
3.
go back to reference McGuire EJ, Cespedes RD, O’Connel HE (1996) Leak point pressures. Urol Clin North Am 23:253–262PubMedCrossRef McGuire EJ, Cespedes RD, O’Connel HE (1996) Leak point pressures. Urol Clin North Am 23:253–262PubMedCrossRef
4.
go back to reference Nitti VW, Combs AJ (1996) Correlation of valsalva leak point pressure with subjective degree of stress urinary incontinence in women. J Urol 155:281–285PubMedCrossRef Nitti VW, Combs AJ (1996) Correlation of valsalva leak point pressure with subjective degree of stress urinary incontinence in women. J Urol 155:281–285PubMedCrossRef
5.
go back to reference Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P (2002) International Continence Society. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P (2002) International Continence Society. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef
6.
go back to reference Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, Chapple CR, Kaplan S, Tubaro A, Aiyer LP, Wein AJ (2009) The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the epidemiology of LUTS (EpiLUTS) study. BJU Int 104(3):352–360PubMedCrossRef Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, Chapple CR, Kaplan S, Tubaro A, Aiyer LP, Wein AJ (2009) The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the epidemiology of LUTS (EpiLUTS) study. BJU Int 104(3):352–360PubMedCrossRef
7.
go back to reference Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ (2003) Prevalence and burden of overactive bladder in the United States. World J Urol 20(6):327–336PubMed Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ (2003) Prevalence and burden of overactive bladder in the United States. World J Urol 20(6):327–336PubMed
8.
go back to reference Gamble TL, Botros SM, Beaumont JL, Goldberg RP, Miller JJ, Adeyanju O, Sand PK (2008) Predictors of persistent detrusor overactivity after transvaginal sling procedures. Am J Obstet Gynecol 199(6):e691–e697CrossRef Gamble TL, Botros SM, Beaumont JL, Goldberg RP, Miller JJ, Adeyanju O, Sand PK (2008) Predictors of persistent detrusor overactivity after transvaginal sling procedures. Am J Obstet Gynecol 199(6):e691–e697CrossRef
9.
go back to reference Fulford SC, Flynn R, Barrington J, Appanna T, Stephenson TP (1999) An assessment of the surgical outcome and urodynamic effects of the pubovaginal sling for stress incontinence and the associated urge syndrome. J Urol 162(1):135–137PubMedCrossRef Fulford SC, Flynn R, Barrington J, Appanna T, Stephenson TP (1999) An assessment of the surgical outcome and urodynamic effects of the pubovaginal sling for stress incontinence and the associated urge syndrome. J Urol 162(1):135–137PubMedCrossRef
10.
go back to reference Paick JS (2008) OS, Kim SW, Ku JH. Tension-free vaginal tape, suprapubic arc sling, and transobturator tape in treatment of mixed urinary incontinence in women. Int Urogynecol J Pelvic Floor Dysfunct 19(1):123–129PubMed Paick JS (2008) OS, Kim SW, Ku JH. Tension-free vaginal tape, suprapubic arc sling, and transobturator tape in treatment of mixed urinary incontinence in women. Int Urogynecol J Pelvic Floor Dysfunct 19(1):123–129PubMed
Metadata
Title
Detrusor overactivity leak point pressure in women with urgency incontinence
Authors
Ariana L. Smith
William I. Jaffe
Mary Wang
Alan J. Wein
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 4/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1587-9

Other articles of this Issue 4/2012

International Urogynecology Journal 4/2012 Go to the issue