title: Traces: making sense of urodynamics testing--part 7: Evaluation of bladder filling/storage: Evaluation of urethral sphincter incompetence and stress urinary incontinence.
abstract: The "Traces" series discusses how the urodynamic clinician generates usable data from a filling cystometrogram. Part 7 focuses on the question, "Is the urethral sphincter mechanism competent?" From a practical viewpoint, this question can be divided into two queries: 1) does this patient have observable urodynamic stress urinary incontinence (SUI), and 2) does this patient have intrinsic urethral sphincter incompetence, also referred to as intrinsic sphincter deficiency or a low pressure urethra? Signs of SUI include clinician observation of urine loss with coughing or during Valsalva's maneuver. Urodynamic SUI is the observation of urine loss with increased abdominal and intravesical pressures in the absence of a detrusor contraction. The most commonly used techniques for assessment of urethral sphincter function and SUI are the urethral pressure profile and the abdominal leak point pressure. Both are useful for answering these queries, but both tests are vulnerable to physiologic and technical artifacts that must be minimized to produce technically accurate and clinically meaningful results.
authors.affiliation: Department of Urology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Mikel
authors.initials: M
authors.lastname: Gray
mesh_terms: D003950:Diagnostic Techniques, Urological / Q000451:nursing*; D006801:Humans; D013041:Specialties, Nursing / Q000379:methods*; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000502:physiology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000451:nursing / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*