Extended analysis of urethral profilometry in women with urinary stress incontinence – preliminary report

Abstract

Summary Stress urinary incontinence (SUI) is the most common kind of urinary incontinence in women. Treatment efficiency depends on the type of stress urinary incontinence. Objectives: The purpose of the following study was to compare certain urethral profilometry parameters, including additional ones, in women with stress urinary incontinence (type 0) and women categorized as a ‘transitional group’ who were likely to have the mechanism of the intrinsic sphincter deficiency in pathogenesis of SUI. Material and methods: Examinations included 100 patients with diagnosed SUI based on medical history, clinical evaluation, pad test and urodynamic evaluation. Studied population was divided into three groups depending on the presence of leakage and VLPP value in the urodynamic test. The first group consisted of 19 patients with no leakage during urodynamic test (with SUI type 0), the second group (2) comprised 30 patients with VLPP 60-89 cmH20 and the third group included 36 patients with VLPP ≥90 cmH2O. 15 patients with leakage appearing at VLPP <60 cmH20 were excluded from the study. The final analysis was carried out in a group of 85 patients. The analysed urethral profilometry parameters included: (MUCP, cmH2O ), (Total Profile Area, cmH2O mm), (Profile Length to Peak, mm), (Proximal Area to Peak cmH2O mm), (Distal Area after Peak, cmH2O mm). Results: Most of the analyzed urethral profilometry parameters, excluding Profile Length to Peak, in the group of patients with VLPP 60-89 cmH2O have revealed significantly lower values of MUCP than in the group with no leakage. No significant differences of the analyzed parameters between group 1 and group 3 and between group 2 and group 3 have been revealed although their values were slightly elevated in the group of patients with critical VLPP. Conclusion: Lower values of fields under the urethral profilometry curve can suggest a greater urethral closing mechanism deficiency and the coexistence of the external sphincter insufficiency. This parameter can be very useful in the group of patients with moderate leakage point.