Association between valsalva and cough leak point pressures and pelvic organ prolapse quantification in women with stress incontinence.
OBJECTIVE
Women with urodynamically documented stress urinary incontinence (SUI) and urethral hypermobility may have a higher pelvic organ prolapse quantification (POP-Q) stage according to anterior POP-Q measurements. In this study we determined if POP-Q system anterior components representing the urethrovesical junction (anterior wall point Aa/Ba) and/or POP-Q stage has a relationship with leak point pressure testing.


METHODS
Of the 1,511 women who underwent video fluoro-urodynamics during 1997 to 2003 at our institution 88 with only evidence of SUI with negative Valsalva leak point pressure and positive cough leak point pressure (CLPP) were selected.


RESULTS
Average patient age was 58.6 years (range 32 to 89). Of the 88 women 82 had complete POP-Q examinations available, which revealed stages 0 to III in 21 (25.61%), 20 (24.39%), 40 (48.78%) and 1 (1.22%), respectively. The association between POP-Q stage/components and positive CLPP showed no significant difference in mean positive CLPP among POP-Q stages (p = 0.178) or components (p = 0.42 to 0.97). The test for linear trend was not significant (p = 0.636) for POP-Q stages/components (p = 0.40 to 0.93). No significant difference in volume at which positive CLPP occurred was observed among POP-Q stages (p = 0.283) or components (p = 0.13 to 0.75). The proportion of patients with leakage at 200 cc did not differ significantly among POP-Q stages (p = 0.119) or components (p = 0.15 to 0.60).


CONCLUSIONS
Analysis of women with urodynamic evidence of SUI with negative Valsalva leak point pressure and positive CLPP did not show any significant association with components of the POP-Q system or with POP-Q stages. Findings support that POP-Q measurements should not be interpreted as indicators of urethral hypermobility when evaluating women with SUI.
Latini
Jerilyn M
JM
Department of Urology, University of Iowa, Iowa City 52242-1089, USA.
Zimmerman
M Bridget
MB
Kreder
Karl J
KJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002933:Cineradiography; D015331:Cohort Studies; D003371:Cough / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D011312:Pressure; D011391:Prolapse; D012189:Retrospective Studies; D016683:Supine Position / Q000502:physiology; D014522:Urethral Diseases / Q000175:diagnosis / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000145:classification / Q000503:physiopathology* / Q000652:urine; D014563:Urodynamics / Q000502:physiology; D014636:Valsalva Maneuver / Q000502:physiology*