Urodynamic study in women with pure stress urinary incontinence

Prevalence of "uncomplicated" and "complicated" stress urinary incontinence in Argentinian women: Assessing the role of the urodynamic study

OBJECTIVE

To determine the percentage of Argentinian patients with "uncomplicated" and "complicated" stress urinary incontinence (SUI) in whom preoperative urodynamics study (UDS) was performed. The secondary objective of the study was to evaluate differences between clinical observation and urodynamics in both groups of women.

METHODS

A retrospective study of women with IOE derivatives for UDS prior to surgical treatment is performed. The analyzed patients were classified in complicated and not complicated according to the criteria of the study VALUE. The prevalence of different urodynamics observations was assessed in patients with complicated and uncomplicated SUI.

RESULTS

We studied 792 patients with SUI derivatives for UDS. Of the patients studied, 313 (39.5%) were considered as uncomplicated SUI and 479 (60.5%) as complicated SUI. The Urodynamics observation was considered different from the clinical data in 415/792 (52.4%), although in greater proportion in SUI complicated (59.9% vs. 40.9%, p < 0.001). There was a higher incidence of voiding dysfunction in patients with complicated SUI (32.4% vs. 14.7%, p < 0,001).

CONCLUSIONS

Patients with uncomplicated SUI represent 39% of patients studied with SUI. The differences between clinical evaluation and urodynamics are higher in patients with complicated SUI contributing new information in 60% of the cases.

Correlation of Xiphopubic Distance, Body Weight, Height and Body Mass Index with Intravesical and Abdominal Initial Resting Pressures in Urodynamic Testing in the Sitting Position

OBJECTIVES

To compare the initial resting intravesical pressure (p_ves ) and abdominal pressure (p_abd ) in the sitting position with the typical range of values, to assess the correlation between such pressures and patient xipho-pubic distance, body weight, height and body mass index (BMI), and to estimate if xipho-pubic distance can be a guide to interpret initial resting pressures in urodynamic testing.

METHODS

Women with lower urinary tract symptomatology referred for urodynamic testing were consecutively enrolled in a prospective study. Conventional cystometry was done following "good urodynamic practices". The correlation between initial resting p_ves and p_abd and xipho-pubic distance, body weight, height and BMI were studied using simple and multiple linear regression analysis. Statistical significance was defined as P < 0.05.

RESULTS

One hundred women aged (mean ± SD) 59.2 ± 13.3 were studied. There was a significant correlation between both p_ves and p_abd , and xipho-pubic distance, body weight and BMI and no correlation with height. Over the multiple analysis, xipho-pubic distance and body weight correlated independently with p_ves ; body weight correlated independently with p_abd . Three patients had p_ves and/or p_abd out of typical range, with BMIs values of 18.48, 18.72 and 35.81 kg/m² . There was a wide range of difference between xipho-pubic distance and initial resting pressures.

CONCLUSIONS

Out of range initial resting pressures occur in underweight (or close to) or severely obese patients. Xipho-pubic distance and body weight correlated independently with p_ves . Body weight correlated independently with p_abd . Xipho-pubic distance cannot be a guide to interpret the initial resting pressures.