Top

Published in:

01-12-2007 | Original Article

Opening vesical pressure: a new test to discriminate urethral sphincter deficiency?

Authors: Stefano Salvatore, Maurizio Serati, Vik Khullar, Fabio Ghezzi, Paola Triacca, Alessandro Digesù, Paolo Beretta, Pier Francesco Bolis

Published in: International Urogynecology Journal | Issue 12/2007

Abstract

Urethral sphincter deficiency (USD) is not standardised. Opening vesical pressure could reflect the pressure exerted to overcome urethral resistance during void; thus, we evaluated if it could discriminate USD. Women with urinary symptoms were prospectively assessed with a questionnaire and urodynamics and divided into three groups: urodynamic stress incontinence with USD (group 1), urodynamic stress incontinence related to urethral hypermobility without USD (group 2) and normal urodynamic (group 3). USD was defined as the concomitant presence of severe urodynamic stress incontinence, VLPP <60 cm H2O, MUCP <20 cm H2O and urethral mobility <30°. A total of 145 women were enrolled: 56 in group 1, 50 in group 2 and 39 in group 3. The three groups did not differ for demographics, obstetric and surgical history. The median values for opening vesical pressures were 17.5 (15.6–22.2 95%CI), 30 (27.0–37.3 95%CI) and 30 (30.6–44.2 95% CI) for the groups 1, 2 and 3, respectively. A p value <0.0001 was found when comparing group 1 either with group 2 or 3. Opening vesical pressure is a promising parameter to detect USD.

Urinary Incontinence Guideline Panel (1992) Urinary incontinence in adults. Clinical Practice Guideline. AHCPR Pub. No. 92-0038. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Depart ment of Health and Human Services (March)

McGuire EJ, Lytton B, Kohorn EI, Pepe V (1980) The value of urodynamic testing in stress urinary incontinence. J Urol 124:256–258PubMed

Bowen LW, Sand PK, Ostergard DR, Franti CE (1989) Unsuccessful Burch retropubic urethropexy: a case-controlled urodynamic study. Am J Obstet Gynecol 160:452–458PubMed

Ghezzi F, Serati M, Cromi A, Uccella S, Salvatore S, Triacca P, Bolis P (2006) Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency. Int Urogynecol J Pelvic Floor Dysfunct 17:335–339PubMedCrossRef

Rezapour M, Falconer C, Ulmsten U (2001) Tension-free vaginal tape (TVT) in stress incontinent women with intrinsic sphincter deficiency (ISD)—a long-term follow-up. Int Urogynecol J Suppl 2:S12–S14CrossRef

Paick JS, Ku JH, Shin JW, Son H, Oh SJ, Kim SW (2004) Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure. J Urol 172:1370–1373PubMedCrossRef

Liapis A, Bakas P, Salamelekis E, Botsis D, Creatsas G (2004) Tension-free vaginal tape (TVT) in women with low urethral closure pressure. Eur J Obstet Gynecol Reprod Biol 116:67–70PubMedCrossRef

Lose G, Griffiths D, Hosker G, Kulseng-Hanssen S, Perucchini D, Schäfer W, Thin dP, Versi E (2002) Standardisation of urethral pressure measurement: report from the standardisation sub-committee Of The International Continence Society. Neurourol Urodyn 21(3):258–260PubMedCrossRef

Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef

10.

Ferrari A, Baresi L, Frigerio L, Costa M (1986) A grading model for stress urinary incontinence. Urology 27:76–78PubMedCrossRef

11.

Abrams P, Cardozo L, Fall M et al (2003) The standardization of terminology of lower urinary tract function: report from the standardisation sub-committee of the ICS. Urology 61:37–49PubMedCrossRef

12.

DeLancey JOL (1986) Correlative study of paraurethral anatomy. Obstet Gynecol 68(1):91–97PubMed

13.

Oelrich TM (1983) The striated urogenital sphincter muscle in the female. Anat Rec 205:223–232PubMedCrossRef

14.

Weber AM (2001) Is urethral pressure profilometry a useful diagnostic test for stress urinary incontinence? Obstet Gynecol Surv 56(11):720–735PubMedCrossRef

15.

Weil A, Reyes H, Bischoff P, Rottenberg RD, Kruer F (1984) Modification of the urethral rest and stress profiles after different types of surgery for urinary stress incontinence. Br J Obstet Gynaecol 91(1):46–55PubMed

16.

Bump RC, Coates KW, Cundiff GW, Harris RL, Weidner AC (1997) Diagnosing sphincteric deficiency: comparing urethral closure pressure, urethral axis and Valsalva leak point pressures. Am J Obstet Gynecol 177:303–310PubMedCrossRef

17.

Lose G (1997) Urethral pressure measurement. Acta Obstet Gynecol Scand Suppl 166:39–42PubMed

18.

Weber M (2001) Leak point pressure measurement and stress urinary incontinence. Curr Womens Health Rep 1(1):45–52PubMed

19.

Digesu GA, Athanasiou S, Chaliha C, Michalas S, Salvatore S, Selvaggi S, Khullar V (2006) Urethral retro-resistance pressure and urodynamic diagnoses in women with lower urinary tract symptoms. BJOG 113:34–38PubMedCrossRef

20.

Swift SE, Ostergard DR (1995) A comparison of stress leak-point pressure and maximal urethral closure pressure in patients with genuine stress incontinence. Obstet Gynecol 85:704–708PubMedCrossRef

21.

McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA (1993) Clinical assessment of urethral sphincter function. J Urol 150:1452–1454PubMed

22.

Versi E, Cardozo L, Studd JW, Brincat M, O’Dowd TM, Cooper DJ (1986) Internal urinary sphincter in maintenance of female continence. Br Med J (Clin Res Ed) 292(6514):166–167CrossRef

23.

Theofrastous JP, Bump RC, Elser DM (1995) Correlation of Valsalva Leak Point Pressure and urethral pressure profilometry variables with measures of incontinence severity in women with pure genuine stress incontinence. Am J Obstet Gynecol 173:407–414PubMedCrossRef

24.

Petrou SP, Wan J (1999) VLPP in the evaluation of the female with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 10(4):254–259PubMedCrossRef

25.

Bonney V (1923) On diurnal incontinence of urine in women. J Obstet Gynaecol Br Emp 30:324

26.

Slack M, Culligan P, Tracey M, Hunsicker K, Patel B, Sumeray M (2004) Relationship of urethral retro-resistance pressure to urodynamic measurements and incontinence severity. Neurourol Urodyn 23(2):109–114PubMedCrossRef

27.

Slack M, Tracey M, Hunsicker K, Godwin A, Patel B, Sumeray M (2004) Urethral retro-resistance pressure: a new clinical measurements of urethral function. Neurourol Urodyn 23(7):656–661PubMedCrossRef

28.

Athanasiou S, Khullar V, Boos K, Slavatore S, Cardozo L (1999) Imaging the urethral sphincter with three-dimensional ultrasound. Obstet Gynecol 94:295–301PubMedCrossRef

29.

Cucchi A (1999) Sequential changes in voiding dynamics related to the development of detrusor instability in women with stress urinary incontinence. Neurourol Urodyn 18(2):73–80PubMedCrossRef

Title: Opening vesical pressure: a new test to discriminate urethral sphincter deficiency?
Authors: Stefano Salvatore
Maurizio Serati
Vik Khullar
Fabio Ghezzi
Paola Triacca
Alessandro Digesù
Paolo Beretta
Pier Francesco Bolis
Publication date: 01-12-2007
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 12/2007
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-007-0379-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Opening vesical pressure: a new test to discriminate urethral sphincter deficiency?

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2007

Tension-free vaginal tape: poor intraoperative cough test as a predictor of postoperative urinary retention

Is there an association between depressive and urinary symptoms during and after pregnancy?

A histotopographic study of the perineal body in elderly women: the surgical applicability of novel histological findings

Is there a relation between urinary interleukin-6 levels and symptoms before and after intra-vesical glycosaminoglycan substitution therapy in patients with bladder pain syndrome/interstitial cystitis?

Is anterior genital tract trauma associated with complaints of postpartum urinary incontinence?

Authors should publish their raw data