Genuine Stress Incontinence

Abstract

Urodynamic studies are necessary by definition to establish the diagnosis of genuine stress incontinence with certainty. The classical study performed for this purpose is the cough urethral closure pressure profile. This study is performed by asking the patient to cough at one second intervals with a maximum effort while withdrawing the pressure recording catheter through the urethra at a continuous rate, equal to the paper or recorder speed (i.e. 1 mm/s). While the profile is in progress the true detrusor pressure channel is constantly monitored to detect any increase in detrusor pressure due to a bladder contraction. In addition, the synchrony of urine loss with the individual coughs is noted on the tracing. To optimize sensitivity it is most advantageous to perform this test in an upright position at maximum cystometric capacity. However, standing profiles are difficult to perform and often lead to the early breakdown of profilometers due to water damage.