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KMID : 1240020170210020121
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International Neurourology Journal
2017 Volume.21 No. 2 p.121 ~ p.127
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Urethral Closure Pressure at Stress: A Predictive Measure for the Diagnosis and Severity of Urinary Incontinence in Women
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Pizzoferrato Anne Cecile
Fauconnier Arnaud
Bader Georges
Dompeyre Philippe
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Abstract
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Int Neurourol J > Volume 21(2); 2017 > Article
Original Article
Int Neurourol J 2017; 21(2): 121-127.
Published online: June 21, 2017
DOI: https://doi.org/10.5213/inj.1732686.343
Urethral Closure Pressure at Stress: A Predictive Measure for the Diagnosis and Severity of Urinary Incontinence in Women
Anne-Cecile Pizzoferrato1, 2, Arnaud Fauconnier1, 2, Xavier Fritel3, Georges Bader1, Philippe Dompeyre1
1Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France
2Research unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Versailles St-Quentin University, Montigny-le-Bretonneux, France
3Poitiers University, INSERM CIC1402, University Hospital of Poitiers, Poitiers, France
Corresponding author: Anne-Cecile Pizzoferrato ORCID? Department of Obstetrics and Gynecology and Reproductive Medicine, Poissy Hospital, 10 rue du Champ Gaillard, 78300 Poissy, France? E-mail: acpizzofe@gmail.com / Tel: +33-1-39-27-45-77 / Fax: +33-1-39-37-40-89
Submitted: July 28, 2016 Accepted after revision: August 29, 2016
Copyright ⓒ 2017 Korean Continence Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Purpose: Maintaining urinary continence at stress requires a competent urethral sphincter and good suburethral support. Sphincter competence is estimated by measuring the maximal urethral closure pressure at rest. We aimed to study the value of a new urodynamic measure, the urethral closure pressure at stress (s-UCP), in the diagnosis and severity of female stress urinary incontinence (SUI).
Methods: A total of 400 women without neurological disorders were included in this observational study. SUI was diagnosed using the International Continence Society definition, and severity was assessed using a validated French questionnaire, the Mesure du Handicap Urinaire. The perineal examination consisted of rating the strength of the levator ani muscle (0?5) and an assessment of bladder neck mobility using point Aa (cm). The urodynamic parameters were maximal urethral closure pressure at rest, s-UCP, Valsalva leak point pressure (cm H2O), and pressure transmission ratio (%).
Results: Of the women, 358 (89.5%) were diagnosed with SUI. The risk of SUI significantly increased as s-UCP decreased (odds ratio [OR], 0.92; 95% confidence interval, 0.88?0.98). The discriminative value of the measure was good for the diagnosis of SUI (area under curve>0.80). s-UCP values less than or equal to 20 cm H2O had a sensitivity of 73.1% and a specificity of 93.0% for predicting SUI. The association between s-UCP and SUI severity was also significant.
Conclusions: s-UCP is the most discriminative measure that has been identified for the diagnosis of SUI. It is strongly inversely correlated with the severity of SUI. It appears to be a specific SUI biomarker reflecting both urethral sphincter competence and urethral support.
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KEYWORD
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Urinary Incontinence, Stress, Bladder Neck Descent, Urethral Pressure, Urodynamics
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