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

摘要

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 H(2)O; 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 H(2)O x 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.