Detrusor overactivity leak point pressure in women with urgency incontinence

Int Urogynecol J. 2012 Apr;23(4):443-6. doi: 10.1007/s00192-011-1587-9. Epub 2011 Oct 19.

Abstract

Introduction and hypothesis: When incontinence accompanies detrusor overactivity (DO), the pressure at which it occurs may have important predictive value and should be termed DO leak point pressure (DOLPP).

Methods: A retrospective review of our video urodynamics database (n = 222) including validated questionnaires was performed. DOLPP was defined as detrusor pressure the moment DO incontinence occurred. Statistical analysis was performed using Student's t-test.

Results: Women with DO leakage (47) and with DO without leakage (15) were analyzed. Urgency and urgency incontinence (UUI) were greater among patients with DO leakage. A link between sphincter deficiency and greater severity of UUI was noted. Among patients with DO leakage, those with subjective mixed incontinence had a lower mean DOLPP than those with pure UUI (p = 0.004). The detrusor pressure at peak flow was lower in the DO leakage group (versus DO alone, p = 0.05) likely reflecting a measure of outlet resistance.

Conclusion: DOLPP has predictive meaning in women and should be further studied for possible inclusion in standard urodynamic terminology.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Humans
  • Predictive Value of Tests
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Urinary Bladder, Overactive / diagnosis
  • Urinary Bladder, Overactive / physiopathology*
  • Urinary Incontinence, Urge / physiopathology*
  • Urination / physiology*
  • Urodynamics / physiology*