Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-St Germain en Laye, Poissy, France.
Department of Gynecology and Obstetrics, University Hospital of Caen, Caen, France.
Neurourol Urodyn. 2020 Jun;39(5):1515-1522. doi: 10.1002/nau.24386. Epub 2020 May 11.
We aimed to assess the value of the Valsalva urethral profile (VUP) in case of stress urinary incontinence (SUI).
Six hundred and ninety-four women without pelvic organ prolapse were included in this prospective monocentric study. SUI was diagnosed from symptoms using the International Continence Society definition, and severity using two validated questionnaires (USP and ICIQ-SF). The urodynamic parameters studied were maximal urethral closure pressure (MUCP) and functional length (FL). Both were performed at rest, during a Valsalva maneuver (v-MUCP and v-FL) and again at rest. Correlation analyses and ROC curves were used to assess the value of the clinical and urodynamic measurements.
In our population, based on the questionnaires, 172 (24.8%) women were diagnosed with pure SUI on symptoms, 71 (10.2%) with urgency urinary incontinence and 392 (56.5%) with mixed urinary incontinence; 59 (8.5%) women were continent. The v-MUCP was the most correlated parameter to the severity of SUI (ρ: -0.63) and the most predictive of SUI risk, with a threshold value of 35 cm H O (Se = 0.82, Sp = 0.86). The v-FL was significantly shortened in case of SUI.
The v-MUCP and v-FL are global measurements of urethral resistance during stress. With a threshold value of 35 cm H O, the v-MUCP was the most discriminating parameter for the diagnosis of SUI, with a good reliability.
评估在压力性尿失禁（SUI）病例中，Valsalva 尿道压力图（VUP）的价值。
本前瞻性单中心研究纳入了 694 名无盆腔器官脱垂的女性。SUI 的诊断基于国际尿控协会的定义，通过症状和两个经过验证的问卷（USP 和 ICIQ-SF）进行评估。研究的尿动力学参数包括最大尿道闭合压（MUCP）和功能长度（FL）。在静息、Valsalva 动作时（v-MUCP 和 v-FL）和再次静息时进行测量。使用相关分析和 ROC 曲线评估临床和尿动力学测量的价值。
在我们的人群中，根据问卷，172 名（24.8%）女性被诊断为单纯性 SUI，71 名（10.2%）为急迫性尿失禁，392 名（56.5%）为混合性尿失禁；59 名（8.5%）女性为尿控正常。v-MUCP 与 SUI 严重程度相关性最强（ρ：-0.63），预测 SUI 风险的能力最强，阈值为 35cmH 2 O（Se=0.82，Sp=0.86）。SUI 时 v-FL 显著缩短。
v-MUCP 和 v-FL 是压力下尿道阻力的整体测量指标。v-MUCP 阈值为 35cmH 2 O 时，对 SUI 的诊断最具鉴别力，可靠性良好。
