Cough-induced leak-point pressure - a valid measure for assessing treatment in women with stress incontinence

Background. Presently available urodynamic methods are of little use for as sessing the severity of urinary stress incontinence or for evaluating of tr eatment, Cough-induced leak-point pressure may prove to be a more useful ur odynamic method in these respects. A vaginal anti-incontinence device was u sed to validate this new urodynamic method. Aim. The primary aim was to determine the extent to which cough-induced lea k-point pressure was affected by the vaginal device. Secondary aims were to study the short-term effects of the vaginal device on leakage and urinary flow and to relate the change in cough-induced leak-point pressure to the c hange in leakage as expressed by a short-term pad test. Method's, In a prospective study of 22 women with a history of stress incon tinence, the effect of a new vaginal anti-incontinence device (Conveen Cont inence Guard(R)) on cough-induced leak-point pressure, a short-term pad tes t and urinary flow was studied. Results. Cough-induced leak-point pressure increased from 99.9 to 138.9 cm H2O. while leakage, measured by a short-term pad test, decreased from 22.7 to 3.3 g when using the device. Urinary flow was not significantly reduced by the device. Conclusions. Cough-induced leak-point pressure is a valid, quantitative, dy namic measure of urethral closure function which can be used to study the e ffects of treatment in patients with stress incontinence. The vaginal devic e is effective for treatment of stress incontinence in the short-term, with out reducing urinary flow.