Pantazis Konstantinos, Mikos Themistoklis, Tsiapakidou Sofia, Theodoulidis Iakovos, Petousis Stamatios, Dinas Konstantinos, Schiattarella Antonio, Laganà Antonio Simone, Athanasiadis Apostolos P
Urogynecology Unit, 2nd Department of Obstetrics & Gynecology, Aristotle University of Thessaloniki, Hippokration General Hospital, 546 42 Thessaloniki, Greece.
Urogynecology Unit, 1st Department of Obstetrics & Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 564 29 Thessaloniki, Greece.
Medicina (Kaunas). 2025 Jul 1;61(7):1206. doi: 10.3390/medicina61071206.
: This study aims to evaluate the relevance of urethral pressure profile (UPP) measurements in the diagnosis of urodynamic stress incontinence (USI) in women with stress and mixed urinary incontinence (SUI and MUI). : A cross-sectional chart review was used. All patients who had urodynamic studies (UDSs) in the urogynecology unit of an academic hospital over the last 6 months and complained of SUI or MUI were analyzed. Clinical examination included prolapse grading with the POP-Q system. The presenting symptoms, initial diagnosis before UDS, and results from flow studies-cystometrography (CMG), which included a 1-3-5 cough test at 300-350 mL bladder filling, and urethral pressure profilometry (UPP)-were recorded. < 0.05 was considered significant in all statistical comparison tests; receiver operator characteristic (ROC) curves were also used to determine the best predictor of SUI diagnosis. : In total, 57 women were included in this study, with a mean age of 60.7 (±9.3). Upon UDS, 28 women (49.1%) demonstrated USI (Group 1), while 29 women (50.9%) did not demonstrate USI (Group 2). No differences between the two groups were noted during free uroflowmetry and the filling phase of CMG. However, the women in Group 2 had a significantly lower MUCP, FUL, and post-void residual after pressure flow compared to the women in Group 1 ( = 0.038, 0.003, and 0.04, respectively, upon Student's test for independent parameters). The ROC analysis indicated that when using MUCP and FUL for the diagnosis of USI, the AUCs are 0.663 (0.525-0.782) and 0.756 (0.623-0.861), respectively. : By exhibiting correlations between low MUCP/FUL and USI, UPP appears to be a valid test for USI. The value of UPP in diagnosing USI in those with SUI and MUI appears to be clinically important. Further studies are needed in non-SUI patients, in addition to SUI subgroups and various incontinence treatment groups.
本研究旨在评估尿道压力剖面图（UPP）测量在诊断有压力性尿失禁和混合性尿失禁（SUI和MUI）的女性患者的尿动力学压力性尿失禁（USI）中的相关性。
采用横断面图表回顾法。分析了过去6个月内在一家学术医院的妇科泌尿单元进行尿动力学研究（UDS）并主诉SUI或MUI的所有患者。临床检查包括使用盆腔器官脱垂定量分期系统（POP-Q系统）进行脱垂分级。记录患者的症状、UDS前的初步诊断以及尿流率研究-膀胱压力容积测定（CMG）的结果，CMG包括在膀胱充盈300-350 mL时进行1-3-5次咳嗽试验，以及尿道压力测定（UPP）。在所有统计比较检验中，P<0.05被认为具有统计学意义；还使用了受试者工作特征（ROC）曲线来确定SUI诊断的最佳预测指标。
本研究共纳入57名女性，平均年龄为60.7（±9.3）岁。在进行UDS时，28名女性（49.1%）表现为USI（第1组），而29名女性（50.9%）未表现出USI（第2组）。在自由尿流率测定和CMG的充盈期，两组之间未发现差异。然而，与第1组女性相比，第2组女性在压力性尿流后平均尿道闭合压（MUCP）、功能性尿道长度（FUL）和残余尿量显著更低（在独立参数的Student检验中，P值分别为0.038、0.003和0.04）。ROC分析表明，当使用MUCP和FUL诊断USI时，曲线下面积（AUC）分别为0.663（0.525-0.782）和0.756（0.623-0.861）。
通过显示低MUCP/FUL与USI之间的相关性，UPP似乎是一种有效的USI检测方法。UPP在诊断SUI和MUI患者的USI中的价值似乎具有临床重要性。除了SUI亚组和各种尿失禁治疗组外，还需要对非SUI患者进行进一步研究。
