EVALUATION OF PRESSURE TRANSMISSION RATIOS IN WOMEN WITH GENUINE STRESS-INCONTINENCE AND LOW URETHRAL PRESSURE - A COMPARATIVE-STUDY

Objective: To determine whether women with genuine stress incontinence and low urethral closure pressure (20 cm H2O or lower) had more sever ely impaired pressure transmission to the urethra than women with stre ss incontinence and normal urethral pressures. Methods: Seventy-six wo men who underwent multichannel urodynamic testing were included for co mparative analysis. They were classified into the following groups: ge nuine stress incontinence with low urethral pressure (N = 20), genuine stress incontinence without low urethral pressure (N = 32), and conti nent controls (N = 24). Urodynamic indices and pressure transmission r atios were calculated from static and stress urethral pressure profile s, respectively. Multiple demographic cofactors, urethral mobility, an d previous surgeries were correlated for associations with urodynamic results. Results: Women with stress incontinence and low urethral pres sure were significantly older (57.6 years, P < .0071). There were no d ifferences with regard to urethral mobility and previous surgeries. Me an maximum urethral closure pressure and the distance from the proxima l margin of the urethra to the point of maximum urethral closure press ure were statistically less in women with low urethral pressure. There were no differences in pressure transmission ratios between any of th e study groups. Conlclusion: Because there are no differences in press ure transmission ratios between women with genuine stress incontinence with and without low urethral closure pressure, the higher risk for s urgical failure with low urethral pressure appears to result from anot her pathophysiologic process.