Opening vesical pressure: a new test to discriminate urethral sphincter deficiency?
Urethral sphincter deficiency (USD) is not standardised. Opening vesical pressure could reflect the pressure exerted to overcome urethral resistance during void; thus, we evaluated if it could discriminate USD. Women with urinary symptoms were prospectively assessed with a questionnaire and urodynamics and divided into three groups: urodynamic stress incontinence with USD (group 1), urodynamic stress incontinence related to urethral hypermobility without USD (group 2) and normal urodynamic (group 3). USD was defined as the concomitant presence of severe urodynamic stress incontinence, VLPP <60 cm H2O, MUCP <20 cm H2O and urethral mobility <30 degrees . A total of 145 women were enrolled: 56 in group 1, 50 in group 2 and 39 in group 3. The three groups did not differ for demographics, obstetric and surgical history. The median values for opening vesical pressures were 17.5 (15.6-22.2 95%CI), 30 (27.0-37.3 95%CI) and 30 (30.6-44.2 95% CI) for the groups 1, 2 and 3, respectively. A p value <0.0001 was found when comparing group 1 either with group 2 or 3. Opening vesical pressure is a promising parameter to detect USD.
Salvatore
Stefano
S
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Via del Ponte, 19, 21100 Varese, Italy. stefanosalvatore@hotmail.com
Serati
Maurizio
M
Khullar
Vik
V
Ghezzi
Fabio
F
Triacca
Paola
P
Digesù
Alessandro
A
Beretta
Paolo
P
Bolis
Pier Francesco
PF
D001003:Anal Canal / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011312:Pressure; D011795:Surveys and Questionnaires; D014522:Urethral Diseases / Q000175:diagnosis*