Difference of Cough and Valsalva Maneuvers in the Dynamic Testing of Stress Urinary Incontinence.
- Author:
Dong Deuk KWON
1
;
Seung Il JUNG
;
Bong Ryoul OH
;
Kwang Sung PARK
;
Soo Bang RYU
;
Yang Il PARK
Author Information
- Publication Type:Original Article
- Keywords: Cough leak-point pressure; Valsalva leak-point pressure; Maximal urethral closure pressure; Stress incontinence
- MeSH: Catheters; Cough*; Female; Humans; Pelvic Floor; Urinary Bladder; Urinary Incontinence*; Valsalva Maneuver*
- From:Journal of the Korean Continence Society 2001;5(2):57-63
- CountryRepublic of Korea
- Language:Korean
- Abstract: PURPOSE: The aim of the study was to evaluate the relationship between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP) in the patients with stress incontinence and to determine the correlation between maximal urethral closure pressure(MUCP) and leak point pressure. MATERIALS AND METHODS: Thirty women with stress urinary incontinence were included. Two women were excluded from the evaluation because of detrusor instability. At the bladder volume of 200-300ml cough leak-point pressure and Valsalva leak-point pressure were measured in the sitting position by using 8Fr intravesical catheter. RESULTS: Valsalva leak-point pressure was significantly lower than cough leak-point pressure (69.4+/-24.5 versus 86.6+/-28.1cmH2O, p<0.0001). If intrinsic sphincter deficiency was defined as a leak-point pressure of 60cmH2O or less, 21.4% of women fulfilled this criterion using the cough leak-point pressure compared to 42.8% if the Valsalva leak-point pressure is used. Valsalva leak-point pressure and maximal urethral closure pressure were statistically correlated (p<0.05). However, a correlation coefficient of 0.38 demonstrated poor clinical relationship. CONCLUSION: Cough leak-point pressures were significantly higher than Valsalva leak-point pressures. Cough and Valsalva maneuvers seem to result in a different reaction of the pelvic floor. Valsalva leak-point pressure has more statistical correlation to the maximal urethral closure pressure than cough leak-point pressure. So Valsalva leak-point pressure may have a additional benefit for detecting type III stress urinary incontinence. However, variations in Valsalva leak-point pressure measurement must be precisely descibed, standardized, and validated before a technique can be advocated for clinical use.
