Original research
Computer-assisted virtual urethral pressure profile in the assessment of female genuine stress incontinence

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Abstract

OBJECTIVE: To compare computer-assisted virtual urethral pressure profile changes between women with and without genuine stress incontinence.

METHODS: A full urogynecologic assessment including conventional urodynamic measurements and a clinical stress test were carried out. Computer-assisted virtual urethral pressure profile uses conventional urethral pressure profile measurements during stress, with the only change being that withdrawal of the catheter is stopped at distinct points along the whole urethra while the patient coughs. Cough-related changes of maximal urethral closure pressure, functional urethral length, and area under the urethral closure pressure curve were determined.

RESULTS: Sixty-one women were enrolled in our study: 30 symptom-free women (group A) were continent, and genuine stress incontinence was present in 31 patients (group B) complaining of urinary loss. Significant differences between group A and group B women were found for all parameters of computer-assisted virtual urethral pressure profile including maximal urethral closure pressure (91.59 ± 39.00 versus 20.70 ± 22.61 cm H2O; P < .001), functional urethral length (31.81 ± 9.02 versus 10.83 ± 10.76 mm; P < .001), and the area under the urethral closure pressure curve (2036 ± 1025.29 versus 253 ± 206.69 cm H2O × mm; P < .001).

CONCLUSION: Computer-assisted virtual urethral pressure profile is a new application of urethral pressure profile measurements during stress. Our data show significant differences between continent women and patients with genuine stress incontinence. Further studies are needed to assess the potential of computer-assisted virtual urethral pressure profile for diagnosing genuine stress incontinence.

Section snippets

Materials and methods

A total of 31 women complaining of urinary loss during stress and seen in the urogynecologic unit of the Department of Gynecology, Martin-Luther-University Halle-Wittenberg between July 1999 and December 1999 were enrolled in our study. Moreover, 30 healthy and symptom-free women admitted to our hospital because of other gynecologic diseases (uterine bleeding, n = 17; breast cancer, n = 13) served as controls. All subjects gave written informed consent for the urogynecologic investigations. The

Results

Group-specific demographic descriptions of continent women and patients with genuine stress incontinence are presented in Table 1. According to the results of our urogynecologic evaluation, we identified two groups of women. As was to be expected, no incontinence was present during urogynecologic investigation in 30 symptom-free women (group A). Genuine stress incontinence was present in 31 symptomatic patients (group B). No difference between group A and B patients was found for Pclo and for

Discussion

Compared with conventional urethral pressure profile measurements at rest, significant differences for all parameters of computer-assisted virtual urethral pressure profile were found in our study between patients with genuine stress incontinence and continent women. The famous physician Heisenberg stated in 1927 that no object in nature can be measured without being deranged and transformed.12 Urethral pressure measurements by means of a transurethral catheter take place in a totally

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