CORRELATION OF URODYNAMIC MEASURES OF URETHRAL RESISTANCE WITH CLINICAL MEASURES OF INCONTINENCE SEVERITY IN WOMEN WITH PURE GENUINE STRESS-INCONTINENCE

OBJECTIVE: Our aim was to correlate multiple measures of urethral resi stance with five clinical measures of incontinence severity in women w ith pure genuine stress incontinence. STUDY DESIGN: Seventy-five women with pure genuine stress incontinence underwent passive and dynamic u rethral pressure profilometry and Valsalva leak point pressure determi nations. The standardized and validated measures of incontinence sever ity included (1) the number of incontinent episodes, (2) the number of continence pads used recorded in a prospective 1-week urinary diary, (3) grams of fluid loss on a pad quantitation test, and (4) two condit ion-specific quality-of-life scales, the urogenital distress inventory and the incontinence impact questionnaire. The urodynamic and severit y measures were compared with Pearson product-moment correlation analy sis. RESULTS: There were no significant correlations between dynamic u rethral pressure profile pressure transmission ratios and any measure of incontinence severity. Passive urethral pressure profile variables correlated significantly with incontinence episodes and pad use. Valsa lva leak point pressures correlated significantly with pad use and qua ntitation testing. None of the urodynamic measurements was significant ly correlated with either of the quality-of-life scales, but our power to demonstrate a correlation was limited. CONCLUSIONS: Both passive u rethral pressure profile measures and Valsalva leak point pressures co rrelate with some severity measures of genuine stress incontinence. Al though inefficient pressure transmission during stress is critical to the pathogenesis of genuine stress incontinence, the severity of the p ressure transmission defect is not related to clinical severity. Conve rsely, impairment of intrinsic urethral resistance is not essential to the pathogenesis of genuine stress incontinence, but the degree of sp hincteric impairment is related to severity once the condition exists.