title: Clinical factors associated with low valsalva leak point pressure among women with stress urinary incontinence.
abstract: OBJECTIVE
  The purpose of this study is to determine the predictive factors that are associated with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) in women.
  
  
  METHODS
  Between January 2008 and December 2009, 185 women with urodynamically proven SUI were included in this study and retrospectively reviewed the medical record. Preoperative SUI symptoms were classified by Stamey grade. Valsalva leak point pressure (VLPP) determination series was repeated two times in each subject after finishing one series of VLPP measurement. The patients were classified into three groups according to VLPP; 1) ISD: VLPP≤60 cm H(2)O, 2) equivocal: 60<VLPP≤90 cm H(2)O, 3) anatomical incontinence (AI): VLPP>90 cm H(2)O. Chi-square test and multivariate (logistic regression test) analyses were performed to determine the factors associated with ISD.
  
  
  RESULTS
  The mean patient age was 54.2 years (range, 44.5 to 68.4 years). Seventy-one women (38.3%) were in the ISD group and 70 (37.8%) in the AI group. The results of univariate and multivariate analyses found that women with ISD had a higher symptom grade than women with AI (P=0.001 and 0.0001, respectively). The number of patients in the ISD and AI group in accordance with the symptom grade were 7 (10%) and 44 (62%) in grade I, 50 (54%) and 23 (25%) in grade II, and 14 (63%) and 3 (14%) in grade III respectively. There was no correlation between VLPP and other clinical factors.
  
  
  CONCLUSIONS
  High symptom grade was the only independent clinical factor that predicted the presence of ISD. This should be considered when counseling the patients with SUI.
authors.affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sun-Ouck
authors.initials: SO
authors.lastname: Kim
authors.forename: Young Jung
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Yoo
authors.forename: In Sang
authors.initials: IS
authors.lastname: Hwang
authors.forename: Eu Chang
authors.initials: EC
authors.lastname: Hwang
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Jung
authors.forename: Taek Won
authors.initials: TW
authors.lastname: Kang
authors.forename: Dongdeuk
authors.initials: D
authors.lastname: Kwon
authors.forename: Kwangsung
authors.initials: K
authors.lastname: Park