Detrusor overactivity leak point pressure in women with urgency incontinence.
OBJECTIVE
When incontinence accompanies detrusor overactivity (DO), the pressure at which it occurs may have important predictive value and should be termed DO leak point pressure (DOLPP).


METHODS
A retrospective review of our video urodynamics database (n = 222) including validated questionnaires was performed. DOLPP was defined as detrusor pressure the moment DO incontinence occurred. Statistical analysis was performed using Student's t-test.


RESULTS
Women with DO leakage (47) and with DO without leakage (15) were analyzed. Urgency and urgency incontinence (UUI) were greater among patients with DO leakage. A link between sphincter deficiency and greater severity of UUI was noted. Among patients with DO leakage, those with subjective mixed incontinence had a lower mean DOLPP than those with pure UUI (p = 0.004). The detrusor pressure at peak flow was lower in the DO leakage group (versus DO alone, p = 0.05) likely reflecting a measure of outlet resistance.


CONCLUSIONS
DOLPP has predictive meaning in women and should be further studied for possible inclusion in standard urodynamic terminology.
Department of Surgery, Division of Urology, University of Pennsylvania School of Medicine, Perelman Center for Advanced Medicine, Philadelphia, PA 19104, USA. ariana.smith@uphs.upenn.edu
Ariana L
AL
Smith
William I
WI
Jaffe
Mary
M
Wang
Alan J
AJ
Wein
D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000503:physiopathology*; D053202:Urinary Incontinence, Urge / Q000503:physiopathology*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology*