PRESSURE TRANSMISSION RATIO - IS IT A RELIABLE PARAMETER IN INCREASEDURETHRO-VESICAL JUNCTION MOBILITY

Our objective was to investigate ally correlation between the degree o f urethro-vesical junction (UVJ) mobility and the pressure transmissio n ratio (PTR) values. Five hundred and nineteen patients suffering fro m stress urinary incontinence were divided into four groups according to their degree of UVJ mobility assessed by the Q-tip test method: gro up 1 (N = 86), urethral axis at stress (UAS) <30 degrees; group 2 (N = 191), UAS 31-60 degrees; group 3 (:N = 214), UAS 61-90 degrees; and g roup 4 (N = 28), UAS >90 degrees. A urethral pressure profile at stres s was determined in the supine and standing positions, and PTR was cal culated in the middle region of urethral functional length. PTR values for groups 2-4 were compared with those for group I. In the supine po sition, the values for groups 3 and 4 were lower than for group 1, whi le in the standing position, only the values for group 3 were differen t. The incidence of normal PTR values (i.e., >90%) was the same in all four groups. Overall correlation between PTR values and degree of UVJ mobility was weak (r = 0.14). We conclude that PTR values does not co rrelate with UVJ mobility in those patients with a Q-tip test of <60 d egrees. This correlation is inconstant when the Q-tip test was >60 deg rees. Also, 14-30% of patients in all four groups had normal standing PTR values. This may be explained by well-preserved innervation with s evere alteration of the anchoring bladder neck structures. (C) 1997 Wi ley-Liss, Inc.