Urodynamics, the supine empty bladder stress test, and incontinence severity.
OBJECTIVE
Determine whether urodynamic measures of urethral function [(valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), functional urethral length (FUL)] and the results of the supine empty bladder stress test (SEBST) correlate with each other and with subjective and objective measures of urinary incontinence (UI).


METHODS
Data were collected preoperatively from subjects enrolled in a multicenter surgical trial of mid-urethral slings. Subjective measures included questionnaire scores from the Medical Epidemiological and Social Aspects of Aging Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Objective measures included a 24-hr pad weight test, incontinence episode frequency on a 3-day voiding diary, and a SEBST.


RESULTS
Five hundred ninety-seven women enrolled. Three hundred seventy-two women had valid VLPP values; 539 had valid MUCP/FUL values. Subjective measures of severity had weak to moderate correlation with each other (r = 0.25-0.43) and with objective measures of severity (r = -0.06 to 0.45). VLPP and MUCP had moderate correlation with each other (r = 0.36,  P< 0.001). Urodynamic measures of urethral function had little or no correlation with subjective or objective measures of severity. Subjects with a positive SEBST had more subjective and objective severity measures compared to the negative SEBST group, but they did not have significantly different VLPP and MUCP values.


CONCLUSIONS
VLPP and MUCP have moderate correlation with each other, but each had little or no correlation with subjective or objective measures of severity or with the results of the SEBST. This data suggests that the urodynamic measures of urethral function are not related to subjective or objective measures of UI severity.
Nager
Charles W
CW
Department of Reproductive Medicine, University of California, San Diego, California, USA.
Kraus
Stephen R
SR
Kenton
Kim
K
Sirls
Larry
L
Chai
Toby C
TC
Wai
Clifford
C
Sutkin
Gary
G
Leng
Wendy
W
Litman
Heather
H
Huang
Liyuan
L
Tennstedt
Sharon
S
Richter
Holly E
HE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011237:Predictive Value of Tests; D011312:Pressure; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016683:Supine Position; D011795:Surveys and Questionnaires; D014481:United States; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000295:instrumentation