TY - JOUR
T1 - Urethral pressure reflectometry during intra-abdominal pressure increase—an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women
AU - Saaby, Marie-Louise
AU - Klarskov, Niels
AU - Lose, Gunnar
PY - 2013/11
Y1 - 2013/11
N2 - Aim to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women. Methods Twenty-five urodynamically proven SUI women and eight continent volunteer women were assessed by ICIQ-SF, pad-weighing test, incontinence diary, and UPR. UPR was conducted during resting and increased intra-abdominal pressure (PAbd) by straining. Related values of PAbd and urethral opening pressure (Po) were plotted into an abdomino-urethral pressuregram. Linear regression of the values was conducted, and the slope of the line ("APIR") and the intercept with the y-axis found. By the equation of the line, Po was calculated for various values of PAbd, for example, 50 cm H2O (P o-Abd 50). Results The resting Po (Po-rest) and APIR, respectively, significantly differed in SUI and continent women but could not separate the two groups. The urethral closure equation (UCE) based on Po-rest and APIR provided a more detailed characterization of a woman's closure function based on the permanent closure forces (primarily generated by the urethral sphincteric unit) and the adjunctive closure forces (primarily generated by the support system). Po-Abd 50 and UCE, respectively, which express the combined permanent and adjunctive closure forces and estimate the efficiency of the closure function, separated SUI and continent women and were highly significantly negatively correlated with ICIQ-SF, pad test, and the number of incontinence episodes. Conclusions New parameters for characterization of the urethral closure function and possible dysfunctions and its efficiency were provided. Po-Abd 50 and UCE may be used as diagnostic tests and severity measures.
AB - Aim to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women. Methods Twenty-five urodynamically proven SUI women and eight continent volunteer women were assessed by ICIQ-SF, pad-weighing test, incontinence diary, and UPR. UPR was conducted during resting and increased intra-abdominal pressure (PAbd) by straining. Related values of PAbd and urethral opening pressure (Po) were plotted into an abdomino-urethral pressuregram. Linear regression of the values was conducted, and the slope of the line ("APIR") and the intercept with the y-axis found. By the equation of the line, Po was calculated for various values of PAbd, for example, 50 cm H2O (P o-Abd 50). Results The resting Po (Po-rest) and APIR, respectively, significantly differed in SUI and continent women but could not separate the two groups. The urethral closure equation (UCE) based on Po-rest and APIR provided a more detailed characterization of a woman's closure function based on the permanent closure forces (primarily generated by the urethral sphincteric unit) and the adjunctive closure forces (primarily generated by the support system). Po-Abd 50 and UCE, respectively, which express the combined permanent and adjunctive closure forces and estimate the efficiency of the closure function, separated SUI and continent women and were highly significantly negatively correlated with ICIQ-SF, pad test, and the number of incontinence episodes. Conclusions New parameters for characterization of the urethral closure function and possible dysfunctions and its efficiency were provided. Po-Abd 50 and UCE may be used as diagnostic tests and severity measures.
U2 - 10.1002/nau.22368
DO - 10.1002/nau.22368
M3 - Journal article
C2 - 23532678
SN - 0733-2467
VL - 32
SP - 1103
EP - 1108
JO - Neurourology and Urodynamics
JF - Neurourology and Urodynamics
IS - 8
ER -