Back to Search Start Over

Urethral closure pressure at stress: A predictive measure for the diagnosis and severity of urinary incontinence in women

Authors :
Georges Bader
Philippe Dompeyre
Xavier Fritel
Anne Cécile Pizzoferrato
Arnaud Fauconnier
Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ)
Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Service de gynécologie et obstétrique [CHI Poissy-Saint Germain]
CHI Poissy-Saint-Germain
CIC - Poitiers
Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
HAL UVSQ, Équipe
Source :
International Neurourology Journal, International Neurourology Journal, 2017, 21 (2), pp.121-127. ⟨10.5213/inj.1732686.343⟩, International Neurourology Journal, Vol 21, Iss 2, Pp 121-127 (2017)
Publication Year :
2017
Publisher :
HAL CCSD, 2017.

Abstract

International audience; 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.

Details

Language :
English
ISSN :
20934777
Database :
OpenAIRE
Journal :
International Neurourology Journal, International Neurourology Journal, 2017, 21 (2), pp.121-127. ⟨10.5213/inj.1732686.343⟩, International Neurourology Journal, Vol 21, Iss 2, Pp 121-127 (2017)
Accession number :
edsair.doi.dedup.....150ff4b50d1d8bd8bc57945d78aa9508
Full Text :
https://doi.org/10.5213/inj.1732686.343⟩