Urethral pressure reflectometry and pressure profilometry in healthy volunteers and stress urinary incontinent women

Abstract

Urethral pressure reflectometry (UPR) is a novel reliable method for simultaneous measurement of pressure and cross-sectional area in the female urethra. The aim of this study was to report values for UPR parameters in healthy and stress urinary incontinent (SUI) women and compare UPR with urethral pressure profilometry (UPP) parameters. The study included 30 SUI women and 30 volunteers (23 "continent" and 7 "nearly continent"). The women were examined in the supine position both while relaxed and during squeezing, and upright position. The following UPR variables were measured; opening and closing pressure, opening and closing elastance, hysteresis(absolute) and hysteresis(percent). UPP with the perfusion technique was carried out with the women supine while relaxed and during squeezing. The maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) were obtained. All parameters except the hysteresis(percent) were significantly decreased in the SUI group compared to the volunteers. The squeeze opening pressure increased in all women compared to the resting condition, while MUP and MUCP during squeeze increased in 78% and decreased in 22%. The separation between the continent and SUI women was better using the resting and squeezing opening pressure than the corresponding UPP parameters. UPR is a clinically reliable technique, which provides sound physiological parameters. The resting and squeezing opening pressures separate SUI from continent women better than the UPP parameters. The UPR parameters have the potential to provide a pathophysiologic subdivision of SUI and other dysfunctions.