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Urethral closure pressure at stress: A predictive measure for the diagnosis and severity of urinary incontinence in women
- 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.
- Subjects :
- medicine.medical_specialty
Urethral closure
Urology
Urinary Incontinence, Stress
[SDV]Life Sciences [q-bio]
030232 urology & nephrology
Urinary incontinence
lcsh:RC870-923
03 medical and health sciences
stress
0302 clinical medicine
medicine
030219 obstetrics & reproductive medicine
Urinary continence
business.industry
Urethral sphincter
Odds ratio
Urethral pressure
lcsh:Diseases of the genitourinary system. Urology
Confidence interval
3. Good health
[SDV] Life Sciences [q-bio]
Neck of urinary bladder
Urodynamics
medicine.anatomical_structure
Neurology
Bladder neck descent
Sphincter
Original Article
Neurology (clinical)
medicine.symptom
business
Subjects
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⟩