Weak VLPP and MUCP correlation and their relationship with objective and subjective measures of severity of urinary incontinence

Martan, A; Mašata, Jaromír; Petri, E.; Švabík, Kamil; Drahoradova, Petra; Voigt, R; Pavlı́ková, Markéta; Hlásenská, J

doi:10.1007/s00192-006-0140-8

Cited by 17 publications

(7 citation statements)

References 26 publications

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“…Abdominal leak point pressure is often reduced in patients with SUI, and if it is ≤60 cmH 2 O, then suspect urethral sphincter deficiency . If the Valsalva method is used to increase the intra‐abdominal pressure, it is called Valsalva leak point pressure; if cough is used, it is called cough leak point pressure …”

Section: Diagnosismentioning

confidence: 99%

“…75 If the Valsalva method is used to increase the intra-abdominal pressure, it is called Valsalva leak point pressure; if cough is used, it is called cough leak point pressure. 76,77 Furthermore, pressure flow studies are useful for evaluating voiding disorder pathology; however, currently, there are no defined diagnostic criteria for female lower urinary tract obstruction. 78 -80…”

Section: Urodynamic Study (Uds)mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Guideline for Female Lower Urinary Tract Symptoms

Takahashi

Takei

Nishizawa

et al. 2015

LUTS

127

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The "Japanese Clinical Guideline for Female Lower Urinary Tract Symptoms," published in Japan in November 2013, contains two algorithms (a primary and a specialized treatment algorithm) that are novel worldwide as they cover female lower urinary tract symptoms other than urinary incontinence. For primary treatment, necessary types of evaluation include querying the patient regarding symptoms and medical history, examining physical findings, and performing urinalysis. The types of evaluations that should be performed for select cases include evaluation with symptom/quality of life (QOL) questionnaires, urination records, residual urine measurement, urine cytology, urine culture, serum creatinine measurement, and ultrasonography. If the main symptoms are voiding/post-voiding, specialized treatment should be considered because multiple conditions may be involved. When storage difficulties are the main symptoms, the patient should be assessed using the primary algorithm. When conditions such as overactive bladder or stress incontinence are diagnosed and treatment is administered, but sufficient improvement is not achieved, the specialized algorithm should be considered. In case of specialized treatment, physiological re-evaluation, urinary tract/pelvic imaging evaluation, and urodynamic testing are conducted for conditions such as refractory overactive bladder and stress incontinence. There are two causes of voiding/post-voiding symptoms: lower urinary tract obstruction and detrusor underactivity. Lower urinary tract obstruction caused by pelvic organ prolapse may be improved by surgery.

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Section: Diagnosismentioning

confidence: 99%

Section: Urodynamic Study (Uds)mentioning

confidence: 99%

Clinical Guideline for Female Lower Urinary Tract Symptoms

Takahashi

Takei

Nishizawa

et al. 2015

LUTS

127

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“…No single parameter correlated very highly with either the diagnosis of ISD or even consistently with severity [3]. Subsequent authors have corroborated this, showing that no significant association has been demonstrated between pad test, bladder diary, QOL, and MUCP values [13,14,30]. Bump et al suggested that no single factor be considered absolutely to establish the diagnosis of ISD, and only the combination of urodynamic measurements, patient history, and clinical severity should be used to guide management [3].…”

Section: Correlation With Symptom Severitymentioning

confidence: 99%

Clarifying the Role of Urodynamics in the Preoperative Evaluation of Stress Urinary Incontinence

Fletcher

Lemack

2008

The Scientific World JOURNAL

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It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence (SUI) with urodynamic testing (UDS) enhances surgical outcomes. Nonetheless, UDS is frequently utilized in the assessment of women with SUI in the hopes that results will shed light on preoperative risk factors for failure or postoperative voiding dysfunction. Poorer outcomes for stress incontinence surgery are primarily attributed to intrinsic sphincter deficiency (ISD), detrusor overactivity (DO), and voiding dysfunction. The ability of UDS to identify and characterize those parameters reliably remains under investigation. Furthermore, debate continues regarding the association of each of those factors with postoperative success for various SUI procedures. Since UDS is invasive, costly, and not always available, it is imperative that its benefit be carefully explored. In this review, we discuss the value of UDS in identifying risk factors for poor outcome and how those risk factors are associated with surgical failure.

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“…A later study examined 79 women who underwent both abdominal leak point pressure measurement and urethral pressure profilometry; all had urodynamic stress urinary incontinence without previous surgery and were planned to undergo insertion of mid-urethral tape (TVT). [26] Cutoff values of 60 cmH 2 O for abdominal leak point pressure and 30 cmH 2 O for maximum urethral closure pressure were used to categorize the women. No statistical association between abdominal leak point pressure and maximum urethral closure pressure was found; suggesting they are measuring different pathophysiological events.…”

Section: Resultsmentioning

confidence: 99%

Urodynamic assessment of urinary incontinence

2010

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ContextUrodynamic evaluation in the assessment of women complaining of urinary incontinence remains controversial with recent UK National Institute of Health and Clinical Excellence guidance maintaining that it is unnecessary prior to surgery for women with a primarily stress leakage. Other experts contend it should be part of routine preoperative assessment since it establishes a diagnosis, allows more careful patient counseling and predicts surgical outcome.ObjectivesTo summarize current literature to define the evidence level on which these conflicting opinions are based.Materials and MethodsA systematic literature search was performed and retrieved publications summarized in a narrative evidence review using both original papers and previous reviews.ResultsFive hundred and one primary research papers and 65 previous reviews were retrieved. The findings were summarized in a narrative comprising overview, description of methods of bladder and urethral pressure measurement, and a summary of the literature concerning four key questions.ConclusionThe level of evidence was low regarding answering each of the questions posed, preventing firm conclusions. Urodynamic findings do correlate with relevant symptoms and, to some extent, with symptom severity, giving reasonable diagnostic accuracy. There is no reliable evidence that preoperative urodynamic diagnosis improves outcome from surgery for stress incontinence although it is likely to facilitate preoperative discussion. Tests to differentiate sphincter deficiency and urethral hypermobility are not currently recommended due to poor validity and reproducibility. This along with the current use of mid-urethral tapes as the universal primary surgical procedure means differentiation is not a necessity. Preoperative diagnosis of detrusor overactivity does not appear to worsen surgical outcome in women with a primary symptom of stress leakage. Large, well-designed prospective studies are now underway to provide a definitive answer to these questions.

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Weak VLPP and MUCP correlation and their relationship with objective and subjective measures of severity of urinary incontinence

Cited by 17 publications

References 26 publications

Clinical Guideline for Female Lower Urinary Tract Symptoms

Clinical Guideline for Female Lower Urinary Tract Symptoms

Clarifying the Role of Urodynamics in the Preoperative Evaluation of Stress Urinary Incontinence

Urodynamic assessment of urinary incontinence

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