Is the leak point pressure alone an accurate indicator of intrinsic sphincteric deficiency?

Abstract

The aim of this study was to determine the characteristics of women who meet the criteria for intrinsic sphincteric deficiency (ISD) on maximum urethral closure pressure (MUCP) but not on leak point pressure (LPP) measurement. We performed a cross-sectional chart review of every patient who underwent multichannel, microtransducer urodynamic testing in our center between 1994 and 1996 (n=423). From this population we culled a sub-population of women who fit into one of the following two groups: women with no evidence of ISD on MUCP or LPP and women with evidence of ISD on MUCP only. Logistic regression was used to identify independent predictors of group membership. Increasing age (>60.5 years) and a positive supine empty stress test were the only independent predictors of membership in the group of women with ISD on MUCP only. Knowledge of these risk factors may help clinicians in choosing appropriate pre-operative testing.

Influence of voluntary pelvic floor muscle contraction and pelvic floor muscle training on urethral closure pressures: a systematic literature review

“…Despite this, only four studies had an age range of <10 years [18,30,34,36]; the largest range was 69 years [36]. One study investigated the relationship between augmented MUCP and age and found a negative correlation [33], similar to other findings on resting MUCP [44][45][46]. Clearly, influence of age on augmented MUCP needs to be evaluated.…”

Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence

“…Even if sometimes MUCP is 20 cm of water or less and VLPP is more than 60 cm of water, we can note that studies that have analyzed the risk factor for the failure of continence surgery have only used MUCP of 20 cm water or less as the criterion to define ISD. [23][24][25] Furthermore, ICS did not clearly define ISD, and VLPP cannot be used when patients suffer from a POP of more than grade 1.…”

Laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency: Mid‐term outcomes

“…The main reason starts in its imprecise clinical definition and work‐up. Known also as type III stress incontinence, patients with ISD have a fixed urethra, absent cervical‐urethral hypermobility on Valsalva, with low MUCP and VLPP Treatment options should increase functional urethral length and include injectable urethral bulking agents, insertion of a pubovaginal sling or intracorporeal external urethral compression devices, such as an AUS…”