Characteristic Changes of Cough Urethral Pressure Profile in Stress Urinary Incontinence

Koo, Jeong Mo; Lee, Tchun Yong

Abstract

Urodynamic study developed because physicians recognized that history, physical examination and previous testing modality were inadequate to differentiate between those patients with and those without stress urinary incontinence( SUI). The purpose of this study is to evaluate the practicability and usefulness of the test cough urethral pressure profiler in the evaluation of SUI with objective data. Between November 1991 and October 1993, 45 patients with symptoms of urinary incontinence were studied to determine the value of this test by using microtip transducers of Urocompact 8000 which is a computerized urodynamic system. Dynamic pressure profiles were obtained during cough by measuring the pressure at the proximal, middle and distal urethra. At rest, functional urethral length and maximal urethral closure pressure were 3.01+/-0.58cm, 52.0+/-17.8cmH2O respectively (control 3.66+/-0.35cm, 80.25+/-16.95cmH2Orespectively, p <0.05, p<0.05). During the cough, urethral closure pressure decreased to negative pressure in 41 of 42(98% ) patients who were available for analysis. Three of the 45 patients were not available due to the lack of experience of one. Six months after bladder neck suspension was performed, the urethral pressure profile of four patients were checked again and the results showed that the functional urethral length and maximal urethral closure pressure at rest were greater than those of the preoperative urethral pressure profile, but statistically not significant. In 3 patients who underwent successful treatment, the urethral closure pressure at cough did not decrease to a negative pressure. As a result, the cough urethral pressure profile is a useful and objective diagnostic method of SUI and evaluation of the postoperative state.