The urethral pressure profile and ultrasound imaging of the lower urinary tract

In a prospective study 105 patients with symptoms of stress incontinence un derwent video-urodynamic testing, including resting urethral pressure profi lometry and translabial ultrasound. The urethral pressure profile (UPP) inc luded maximum urethral closure pressure (MUCP), functional length (FL) and area under the curve (AUC). Ultrasound parameters included urethral thickne ss, urethral rotation and bladder neck descent, as well as funneling/openin g of the internal urethral meatus on Valsalva maneuver. Levator contraction strength was assessed measuring the cranioventral displacement of the inte rnal meatus. Negative correlations between UPP data and age, parity and pre vious surgery were observed which were consistent with literature data. The re was a positive correlation :between the urethral AP diameter on ultrasou nd and the MUCP, which agrees with reports showing reduced sphincter thickn ess or volume in stress-incontinent women. Hypermobility on ultrasound did not correlate with UPP data. However, a lower MUCP correlated with extensiv e opening of the bladder neck. Finally, there was a trend towards poorer pe lvic floor function with lower MUCP measurements.