DIAGNOSTICS UTILITY OF THE URETHRAL PRESSURE
PROFILOMETRY IN FEMALE URINARY INCONTINENCE
Article published in Urologia Polska 1998/51/1.
Andrzej Preisner, Piotr Radziszewski, Wojciech Szewczyk
- I Katedra i Klinika Urologii ¦l±skiej AM w Katowicach
Kierownik Kliniki: dr hab. n. med. A. Preisner
urethra urethral pressure profilometry urinary incontinence
- Objectives. This paper deals with the urethral pressure profilometry in the
- different types of the female urinary incontinence.
- Patients and methods. The study included 189 women in the age from 18
- to 74 years (mean 45.8), who undergone urethral pressure profilometry in
- laying position, during rest and when coughing.
- Results. Urinary incontinence was proved and classified in 164 patients, in
- 121 (73.8%) it was classified as genuine stress incontinence, in 15 (9.1%) as
- urge incontinence and in 28 (17.1%) as mixed urinary incontinence (stress
- and urge incontinence). All pressure parameters, it means maximum urethral
- pressure (Puramax) and urethral closure pressure (Puradiff) were the lowest in
- stress and mixed urinary incontinence. Puramax was equal 50.8 ? 10.2 cm H2O and
- 41.2 ? 13.1 cm H2O, respectively, and Puradiff was equal to 39.2 ? 10.1 cm H2O and
- 29.8 ?12.7 cm H2O, respectively. The functional profile length was also significantly
- shorter in stress and mixed urinary incontinence and was equal to 2.7 and 2.8 cm,
- Conclusions. The types of urinary stress incontinence, including these
- coexisting with urgency, are characterized by low urethral pressure parameters
- and short functional profile length.
- Urethral pressure profilometry, performed in the laying position, has the
- limited value in the differential diagnostic of the female urinary incontinence.
-  Abrams, P., Blaivas, J. G., Stanton, S. L., Andersen, I. T.: The standardization
- of terminology of lower urinary tract function. Scand. J. Urol. Nephrol. 1988 (suppl).
-  Awad, S. A., Bryniak, S. R., Lowe, P. I., Bruce, A. W., Twiddy, A. S.: Urethral
- pressure profile in female sterss incontinence. J. Urol. 1978,120,475-479
-  Blaivas, J. G., Olsson, C. A.: Stress incontinence: classification and surgical
- approach. J. Urol. 1987,139, 727-730.
-  Bo, K., Stien, R.:NeedleEMGregistrationofstriatedurethralwallandpelvicfloormuscle
- activity patterns during cought, Valsalva, abdominal, hip adductor, and gluteal muscle
- contractions in nulliparous healthy females. Neurourol. Urodyn. 1994,13,35-41.
-  Brading, A. F., Turner, W. H.: The unstable bladder: towards a common mecha-
- nism. Br. J. Urol. 1994, 73,3-8.
-  Brown, M., Wickham, J. E. A.: The urethral clossure pressure profile. Br.}. Urol.
- 1976, 48, 4-43.
-  Cadogan, M., Awad, S., Field, C, Acker, K., Middleton,: A Comparison of the
- cough and standing urethral pressure profilometry in stress incontinence. Neuro-
- urol. Urodyn. 1988, 7, 327-341.
-  De Lancey, J. O. L.: Functional anatomy of the pelvicfloor and urinary continence
- mechanism. In: Schussler, B., Laycock, J., Norton, R, Stanton, S.(eds): Pelvic Floor
- Reeducation. Principles and Practice. Springer-Verlag, London 1994,9-21.
-  Diokono, A. C, Brown, M. B., Brock, B. M., Herzog, A. R., Normolle, D. R:
- Clinical and cystometric characteristics of continent and incontinenet non in institu-
- tionalized elderly. J. Urol. 1988,140, 567-571.
-  Griffiths, D. J.: Mechanics of micturition. W.: Neurology and Urodynamics. S. V.,
- Yalla, McGuire, E. J., Elbadavi, A., Blaivas, J. G. (eds), McMillan, New York
- 1988, 96-105.
-  Hilton, R, Stanton, S. L.: Urethral pressure measurement by microtransdu-
- cer: the results in symptom free women and in those with sterss-incontinence.
- Br. J. Urol. 1983, 919-933.
-  Hanzal, E., Berger, E., Koebl, E.: Reliability of the urethral closure pressure
- profile during stress in the diagnosis of genuine stress incontinence. Br. J. Urol. 1991,
- 88, 369-371.
-  Kulsen-Hanssen, S., Krostoffersen, H.: Urethral pressure variations in females
- and without neurological symptoms. Scand. J. Urol. Nephrol. 1988,114 (suppl.),
-  McNally, D. S., Whyte, T. D., James, E. D.: Urethral pressure measurement
- using microtip transducers- their validity and effects oftransducer orientation. Neu-
- rourol. Urodyn. 1987, 6,151-152.
-  Meyer, S., de Grandi, R, Caccia, G., Gerber, S.: Pressure Transmission Ratio is
- it a reliable parameter in increased urethro-vesical junction mobility? Neurourol.
- Urodyn. 1997,16, 277-284.
-  Moll, R, Schmidt, S., Schaffer, W., Rubben, H.: The real clinical value of ureth-
- ral clossure pressure profile measurements for diagnosis and treatment of female in-
- continence. Neuro.Urol. Urodyn. 1989,8,362-369, Abstr. No. 52.
-  Raz, S., Caine, M., Zeigler, M.: The vascular component in the production of
- intraurethral pressure. J.Urol. 1972,108,93-96.
-  Schafer, W.: Biomechanical critiaue of current anatomical and functional concepts of
- urethral sphinceterfunction. Neurourol. Urodyn. 1989,8,368-369.
-  Spanberger, A., Torio, H., Engberg, A. i wsp.: Quantification of urethral func-
- tion based on Griffitha model of flow through elastic tube. Neuro. Urol. Urodyn.
- 1989, 8, 25-52.
-  Toews, H. A.: Intraurethral and intravesical pressure in normal and stress-inconti-
- nence women. J. Obst. Gynec. 1967,29,613-634.