Further characterization of the supine empty stress test for predicting low valsalva leak point pressures

The aim of this study is to determine if the diagnostic accuracy of the supine empty stress test (SEST) differs depending on the volume of residual urine. We performed a review of all patients who were diagnosed with stress urinary incontinence (SUI) via multi-channel urodynamics including valsalva leak point determinations (VLPP). A SEST was performed and the residual urine recorded via catheterization. The test-specific indices of the SEST for the prediction of low VLPP (defined as <60 cm H₂0) were determined for varying residual volumes. Ninety-nine patients were included. Regardless of residual volume, low sensitivities, specificities and positive predictive values were demonstrated. Sensitivity and positive predictive values were further reduced and negative predictive values were improved slightly with higher residual volume. The highest negative predictive value was 89% at a residual volume of greater than 10 mL. Residual urine volume has minimal impact on the utility of the SEST.