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Erschienen in: International Urogynecology Journal 6/2010

01.06.2010 | Original Article

Clinical and pathophysiological correlates of the symptom severity of stress urinary incontinence

verfasst von: Jenn-Ming Yang, Shwu-Huey Yang, Shu-Yu Yang, Evelyn Yang, Wen-Chen Huang, Chii-Ruey Tzeng

Erschienen in: International Urogynecology Journal | Ausgabe 6/2010

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Abstract

Introduction and hypothesis

The pathophysiology of stress urinary incontinence (SUI) is multifactorial. The aim of this study was to explore the factor determining the symptom severity of SUI.

Methods

One hundred twenty-four women with SUI were retrospectively investigated. Clinical data for analyses included demographics, pelvic organ prolapse quantification, SUI severity using a 4-point Likert scale, ultrasound, 1-h pad tests, and urodynamic studies. Data were analyzed using the Spearman's rho test and Kruskal–Wallis test.

Results

The symptom severity was not correlated with risk factors of SUI or the morphologic manifestations representing urethral support defect, but was significantly correlated with urine loss on 1-h pad test, Valsalva leak point pressure (VLPP) grading, and maximum urethral closure pressure (MUCP). Women with higher SUI severity had greater urine loss on 1-h pad tests, worse VLPP grading, and lower MUCP.

Conclusions

Urethral sphincter function appears to be an important determinant for the symptom severity of SUI.
Literatur
1.
Zurück zum Zitat Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2004) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61:37–49CrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2004) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61:37–49CrossRef
2.
Zurück zum Zitat Whiteside JL, Walters MD (2007) Pathophysiology of stress urinary incontinence. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery. Mosby, Philadelphia, pp 157–164 Whiteside JL, Walters MD (2007) Pathophysiology of stress urinary incontinence. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery. Mosby, Philadelphia, pp 157–164
3.
Zurück zum Zitat Daneshgari F, Moore C (2006) Advancing the understanding of pathophysiological rationale for the treatment of stress urinary incontinence in women: the “trampoline theory”. BJU Int 98:8–14CrossRefPubMed Daneshgari F, Moore C (2006) Advancing the understanding of pathophysiological rationale for the treatment of stress urinary incontinence in women: the “trampoline theory”. BJU Int 98:8–14CrossRefPubMed
4.
Zurück zum Zitat McGuire EJ, Lytton B, Pepe V, Kohorn EI (1976) Stress urinary incontinence. Obstet Gynecol 47:255–264PubMed McGuire EJ, Lytton B, Pepe V, Kohorn EI (1976) Stress urinary incontinence. Obstet Gynecol 47:255–264PubMed
5.
Zurück zum Zitat Lewicky-Gaupp C, Wei JT, DeLancey JOL, Fenner DE, McGuire EJ, Morgan DM (2008) The association of Incontinence Symptom Index scores with urethral function and support. Am J Obstet Gynecol 199:680e1–680e5 Lewicky-Gaupp C, Wei JT, DeLancey JOL, Fenner DE, McGuire EJ, Morgan DM (2008) The association of Incontinence Symptom Index scores with urethral function and support. Am J Obstet Gynecol 199:680e1–680e5
6.
Zurück zum Zitat Petros PE, Ulmsten UI (1993) An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 153:3–93 Petros PE, Ulmsten UI (1993) An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 153:3–93
7.
Zurück zum Zitat Yalcin I, Viktrup L (2007) Comparison of physician and patient assessments of incontinence severity and improvement. Int Urogynecol J Pelvic Floor Dysfunct 18:1291–1295CrossRefPubMed Yalcin I, Viktrup L (2007) Comparison of physician and patient assessments of incontinence severity and improvement. Int Urogynecol J Pelvic Floor Dysfunct 18:1291–1295CrossRefPubMed
8.
Zurück zum Zitat Albo M, Wruck L, Baker J, Brubaker L, Chai T, Dandreo KJ, for the Urinary Incontinence Treatment Network et al (2007) The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence. J Urol 177:1810–1814CrossRefPubMed Albo M, Wruck L, Baker J, Brubaker L, Chai T, Dandreo KJ, for the Urinary Incontinence Treatment Network et al (2007) The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence. J Urol 177:1810–1814CrossRefPubMed
9.
Zurück zum Zitat Richter HE, Burgio KL, Brubaker L, Moalli PA, Markland AD, Mallet V et al (2005) Urinary Incontinence Treatment Network. Factors associated with incontinence frequency in a surgical cohort of stress incontinent women. Am J Obstet Gynecol 193:2088–2093CrossRefPubMed Richter HE, Burgio KL, Brubaker L, Moalli PA, Markland AD, Mallet V et al (2005) Urinary Incontinence Treatment Network. Factors associated with incontinence frequency in a surgical cohort of stress incontinent women. Am J Obstet Gynecol 193:2088–2093CrossRefPubMed
10.
Zurück zum Zitat Gasquet I, Tcherny-Lessenot S, Gaudebout P, Bosio Le Goux B, Klein P, Haab F (2006) Influence of the severity of stress urinary incontinence on quality of life, health care seeking, and treatment: a national cross-sectional survey. Eur Urol 50:818–825CrossRefPubMed Gasquet I, Tcherny-Lessenot S, Gaudebout P, Bosio Le Goux B, Klein P, Haab F (2006) Influence of the severity of stress urinary incontinence on quality of life, health care seeking, and treatment: a national cross-sectional survey. Eur Urol 50:818–825CrossRefPubMed
11.
Zurück zum Zitat DeLancey JO, Trowbridge ER, Miller JM, Morgan DM, Guire K, Fenner DE et al (2008) Stress urinary incontinence: relative importance of urethral support and urethral closure pressure. J Urol 179:2286–2290CrossRefPubMed DeLancey JO, Trowbridge ER, Miller JM, Morgan DM, Guire K, Fenner DE et al (2008) Stress urinary incontinence: relative importance of urethral support and urethral closure pressure. J Urol 179:2286–2290CrossRefPubMed
12.
Zurück zum Zitat Huang WC, Yang JM (2003) Bladder neck funneling on ultrasound cystourethrography in primary stress incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency. Urology 61:936–941CrossRefPubMed Huang WC, Yang JM (2003) Bladder neck funneling on ultrasound cystourethrography in primary stress incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency. Urology 61:936–941CrossRefPubMed
13.
Zurück zum Zitat Huang WC, Yang SH, Yang JM (2006) Anatomical and functional significance of urogenital hiatus in primary urodynamic stress incontinence. Ultrasound Obstet Gynecol 27:71–77CrossRefPubMed Huang WC, Yang SH, Yang JM (2006) Anatomical and functional significance of urogenital hiatus in primary urodynamic stress incontinence. Ultrasound Obstet Gynecol 27:71–77CrossRefPubMed
14.
Zurück zum Zitat Yang SH, Huang WC, Yang SY, Yang E, Yang JM (2009) Validating new ultrasound parameters for quantifying pelvic floor muscle contraction. Ultrasound Obstet Gynecol 33:465–471CrossRefPubMed Yang SH, Huang WC, Yang SY, Yang E, Yang JM (2009) Validating new ultrasound parameters for quantifying pelvic floor muscle contraction. Ultrasound Obstet Gynecol 33:465–471CrossRefPubMed
15.
Zurück zum Zitat Melville JL, Miller EA, Fialkow MF, Lentz GM, Miller JL, Fenner DE (2003) Relationship between patient report and physician assessment of urinary incontinence severity. Am J Obstet Gynecol 189:76–80CrossRefPubMed Melville JL, Miller EA, Fialkow MF, Lentz GM, Miller JL, Fenner DE (2003) Relationship between patient report and physician assessment of urinary incontinence severity. Am J Obstet Gynecol 189:76–80CrossRefPubMed
16.
Zurück zum Zitat Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed
17.
Zurück zum Zitat Yang JM, Yang SH, Huang WC (2008) Dynamic interaction involved in the tension-free vaginal tape obturator procedure. J Urol 180:2081–2087CrossRefPubMed Yang JM, Yang SH, Huang WC (2008) Dynamic interaction involved in the tension-free vaginal tape obturator procedure. J Urol 180:2081–2087CrossRefPubMed
18.
Zurück zum Zitat Nitti VW, Combs AJ (1996) Correlation of Valsalva leak point pressure with subjective degree of stress urinary incontinence in women. J Urol 55:281–285 Nitti VW, Combs AJ (1996) Correlation of Valsalva leak point pressure with subjective degree of stress urinary incontinence in women. J Urol 55:281–285
19.
Zurück zum Zitat Almeida FG, Bruschini H, Srougi M (2005) Correlation between urethral sphincter activity and Valsalva leak point pressure at different bladder distentions: revisiting the urethral pressure profile. J Urol 174:1312–1315CrossRefPubMed Almeida FG, Bruschini H, Srougi M (2005) Correlation between urethral sphincter activity and Valsalva leak point pressure at different bladder distentions: revisiting the urethral pressure profile. J Urol 174:1312–1315CrossRefPubMed
20.
Zurück zum Zitat Martan A, Mašata J, Petri E, Švabík K, Drahorádová P, Voigt R et al (2007) Weak VLPP and MUCP correlation and their relationship with objective and subjective measures of severity of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:267–271CrossRefPubMed Martan A, Mašata J, Petri E, Švabík K, Drahorádová P, Voigt R et al (2007) Weak VLPP and MUCP correlation and their relationship with objective and subjective measures of severity of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:267–271CrossRefPubMed
21.
Zurück zum Zitat Ku JH, Shin JW, Oh SJ, Kim SW, Paick JS (2006) Clinical and urodynamic features according to subjective symptom severity in female urinary incontinence. Neurourol Urodyn 25:215–220CrossRefPubMed Ku JH, Shin JW, Oh SJ, Kim SW, Paick JS (2006) Clinical and urodynamic features according to subjective symptom severity in female urinary incontinence. Neurourol Urodyn 25:215–220CrossRefPubMed
22.
Zurück zum Zitat Theofrastous JP, Bump RC, Elser DM, Wyman JF, McClish DK (1995) Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence. The Continence Program for Women Research Group. Am J Obstet Gynecol 173:407–414CrossRefPubMed Theofrastous JP, Bump RC, Elser DM, Wyman JF, McClish DK (1995) Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence. The Continence Program for Women Research Group. Am J Obstet Gynecol 173:407–414CrossRefPubMed
23.
Zurück zum Zitat Chen CCG, Rooney CM, Paraiso MF, Kleeman SD, Walters MD, Karram MM et al (2008) Leak point pressure does not correlate with incontinence severity or bother in women undergoing surgery for urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1193–1198CrossRefPubMed Chen CCG, Rooney CM, Paraiso MF, Kleeman SD, Walters MD, Karram MM et al (2008) Leak point pressure does not correlate with incontinence severity or bother in women undergoing surgery for urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1193–1198CrossRefPubMed
24.
Zurück zum Zitat Rud T (1980) Urethral pressure profile in continent women from childhood to old age. Acta Obstet Gynecol Scand 59:331–335CrossRefPubMed Rud T (1980) Urethral pressure profile in continent women from childhood to old age. Acta Obstet Gynecol Scand 59:331–335CrossRefPubMed
25.
Zurück zum Zitat Petros PE (2003) Changes in bladder neck geometry and closure pressure after midurethral anchoring suggest a musculoelastic mechanism activates closure. Neururol Urodyn 22:191–197CrossRef Petros PE (2003) Changes in bladder neck geometry and closure pressure after midurethral anchoring suggest a musculoelastic mechanism activates closure. Neururol Urodyn 22:191–197CrossRef
26.
Zurück zum Zitat Petros PE, Woodman PJ (2008) The Integral theory of continence. Int Urogynecol J 19:35–40CrossRef Petros PE, Woodman PJ (2008) The Integral theory of continence. Int Urogynecol J 19:35–40CrossRef
27.
Zurück zum Zitat Petros PE, Ulmsten U (1997) Role of the pelvic floor in bladder neck opening and closure: I muscle forces, II vagina. Int J Urogynecol Pelvic Floor 8:69–80CrossRef Petros PE, Ulmsten U (1997) Role of the pelvic floor in bladder neck opening and closure: I muscle forces, II vagina. Int J Urogynecol Pelvic Floor 8:69–80CrossRef
28.
Zurück zum Zitat Petros PE, Von Konsky B (1999) Anchoring the midurethra restores bladder neck anatomy and continence. Lancet 354:997–998CrossRefPubMed Petros PE, Von Konsky B (1999) Anchoring the midurethra restores bladder neck anatomy and continence. Lancet 354:997–998CrossRefPubMed
29.
Zurück zum Zitat Fritel X, Fauconnier A, Pigné A (2008) Circumstances of leakage related to low urethral closure pressure. J Urol 180:223–226CrossRefPubMed Fritel X, Fauconnier A, Pigné A (2008) Circumstances of leakage related to low urethral closure pressure. J Urol 180:223–226CrossRefPubMed
Metadaten
Titel
Clinical and pathophysiological correlates of the symptom severity of stress urinary incontinence
verfasst von
Jenn-Ming Yang
Shwu-Huey Yang
Shu-Yu Yang
Evelyn Yang
Wen-Chen Huang
Chii-Ruey Tzeng
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 6/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-1094-4

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