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• W2074212821 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2003Sphincteric Urinary Incontinence: Relationship of Vesical Leak Point Pressure, Urethral Mobility and Severity of Incontinence NICOLE FLEISCHMANN, ADAM J. FLISSER, JERRY G. BLAIVAS, and GEORGIA PANAGOPOULOS NICOLE FLEISCHMANNNICOLE FLEISCHMANN More articles by this author , ADAM J. FLISSERADAM J. FLISSER More articles by this author , JERRY G. BLAIVASJERRY G. BLAIVAS Financial interest and/or other relationship with Eli Lilly, Pharmacia and Yamanouchi. More articles by this author , and GEORGIA PANAGOPOULOSGEORGIA PANAGOPOULOS More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000051895.28240.12AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined the relationships among urethral hypermobility, intrinsic sphincter deficiency and incontinence in women. Materials and Methods: A total of 65 consecutive women with stress urinary incontinence and 28 with lower urinary tract symptoms not associated with stress urinary incontinence were evaluated with videourodynamics, 24-hour voiding diaries and pad tests, vesical leak point pressure measurement and the cotton swab test. Results: A total of 93 patients with a mean age ± SD of 63 ± 13 years were studied, including 65 who presented with stress urinary incontinence and 28 who presented with lower urinary tract symptoms without stress urinary incontinence. The incidence of urethral hypermobility was 32% in the stress urinary incontinence group and 36% in the lower urinary tract symptoms group (p = 0.46). When stress urinary incontinence cases were stratified according to a vesical leak point pressure of 0 to 60, 60 to 90 and greater than 90 cm. H2O, urethral hypermobility was noted in 25%, 31% and 41%, respectively, a difference that was not statistically significant (p = 0.6). Overall incontinent patients with and without urethral hypermobility had the same median number of incontinence episodes (5, range 1 to 13 versus 7, range 1 to 15, p = 0.39) and median pad weight (39.5 range 1 to 693 gm. versus 33.5, range 1 to 751, p = 0.19). When patients with intrinsic sphincter deficiency, defined as vesical leak point pressure less than 60 cm. H2O, were divided into those with and without urethral hypermobility, there were no differences in the mean number of incontinence episodes (9.4 ± 3 versus 6 ± 3.6, p = 0.17) or median pad weight (90 gm., range 10 to 348 versus 86, range 30 to 81, p = 0.76). The degree of change in the urethral angle did not correlate with vesical leak point pressure (r = 0.16, p = 0.24) or with pad weight (r = −0.23, p = 0.1). Conclusions: Urethral hypermobility was equally common in this group of women with lower urinary tract symptoms and stress urinary incontinence. Intrinsic sphincteric deficiency and urethral hypermobility may coexist and they do not define discrete classes of patients with stress urinary incontinence. Urethral hypermobility did not appear to have an independent effect on the frequency or severity of incontinence. Patients with stress urinary incontinence can still be characterized by vesical leak point pressure and change in the urethral angle, although these variables do not always define discrete classes. References 1 : Stress urinary incontinence. Obstet Gynecol1976; 47: 255. Google Scholar 2 : Stress incontinenaaa classification and surgical approach. J Urol1988; 139: 727. Link, Google Scholar 3 : The Raz bladder neck suspension: results in 206 patients. J Urol1992; 148: 845. Link, Google Scholar 4 : The low pressure urethra as a factor in failed retropubic urethropexy. Obstet Gynecol1987; 69: 399. Google Scholar 5 : Experience with pubovaginal slings for urinary incontinence at the University of Michigan. 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Google Scholar From the Department of Urology, Montefiore Medical Center, Departments of Obstetrics and Gynecology and Urology, Joan and Sanford Weill College of Medicine, Cornell University and Lenox Hill Hospital, New York, New York© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byRodriguez A, Hakky T, Hoffman M, Ordorica R and Lockhart J (2018) Salvage Spiral Sling Techniques: Alternatives to Manage Disabling Recurrent Urinary Incontinence in FemalesJournal of Urology, VOL. 184, NO. 6, (2429-2433), Online publication date: 1-Dec-2010.LATINI J, ZIMMERMAN M and KREDER K (2018) ASSOCIATION BETWEEN VALSALVA AND COUGH LEAK POINT PRESSURES AND PELVIC ORGAN PROLAPSE QUANTIFICATION IN WOMEN WITH STRESS INCONTINENCEJournal of Urology, VOL. 173, NO. 4, (1219-1222), Online publication date: 1-Apr-2005.ALMEIDA F, BRUSCHINI H and SROUGI M (2018) CORRELATION BETWEEN URETHRAL SPHINCTER ACTIVITY AND VALSALVA LEAK POINT PRESSURE AT DIFFERENT BLADDER DISTENTIONS: REVISITING THE URETHRAL PRESSURE PROFILEJournal of Urology, VOL. 174, NO. 4 Part 1, (1312-1316), Online publication date: 1-Oct-2005. Volume 169Issue 3March 2003Page: 999-1002 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsurinary incontinenceurethraurodynamicsbladderMetricsAuthor Information NICOLE FLEISCHMANN More articles by this author ADAM J. FLISSER More articles by this author JERRY G. BLAIVAS Financial interest and/or other relationship with Eli Lilly, Pharmacia and Yamanouchi. More articles by this author GEORGIA PANAGOPOULOS More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2074212821 title "Sphincteric Urinary Incontinence: Relationship of Vesical Leak Point Pressure, Urethral Mobility and Severity of Incontinence" @default.
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