Bladder neck competency at rest in women with incontinence

Purpose: We determine the presence of an open bladder neck during video uro dynamic studies and relate that finding to the presence of stress urinary i ncontinence. Materials and Methods: Patients presenting with urinary incontinence, voidi ng dysfunction or pelvic floor prolapse underwent video urodynamics. With t he patient upright and after 200 ml. contrast material had been instilled i nto the bladder the bladder neck was viewed to determine if it was open or closed. At that point the abdominal leak point pressure was measured. Results: Of 102 women, average age 56.5 years (range 31 to 82) 13% had an o pen bladder neck and demonstrable stress incontinence on video urodynamics with an average abdominal leak point pressure of 45 cm. water (range 2 to 9 0). Of those with stress incontinence on urodynamics 23% had an open bladde r neck. No continent patient had an open bladder neck. Conclusions: The presence of an open bladder neck with the bladder filled t o 200 ml.correlates strongly with the presence of stress incontinence.