Differences between cough and Valsalva leak-point pressure in stress incontinent women.
The aim of the study was to evaluate the relationship between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP). Sixty women with stress urinary incontinence were included. One woman was excluded from evaluation because of detrusor instability. At a bladder volume of 200-300 mL (mean, 284; standard deviation, 29) CLPP and VLPP were measured in the sitting position. Intra-abdominal pressure was recorded with a rectal balloon catheter. A standardized pad test and multi-channel urodynamics were performed. VLPP was significantly lower than CLPP (58.9+/-27.6 versus 112.5+/-46.9 cm H(2)O, P<0.0001). Although CLPP was negative in two women only, VLPP was negative in 24 of 59 women (40.1%). If intrinsic sphincter deficiency was defined as a leak-point pressure of 65 cm H(2)O, 16.9% of women fulfilled this criterion using the CLPP compared to 35.6% if the VLPP is used. In conclusion, coughing and Valsalva seem to result in a different reaction of the pelvic floor.
Peschers
U M
UM
Department of Obstetrics and Gynecology, Klinikum Innenstadt Ludwig-Maximilians-Universitaet, Munich, Germany. Ursula.Peschers@fk-i.med.uni-muenchen.de
Jundt
K
K
Dimpfl
T
T
D003371:Cough; D005260:Female; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000503:physiopathology*; D014563:Urodynamics; D014636:Valsalva Maneuver