Swift S E, Ostergard D R
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, USA.
Obstet Gynecol. 1995 May;85(5 Pt 1):704-8. doi: 10.1016/0029-7844(95)00014-i.
To determine the correlation between the maximal urethral closure pressure and the stress leak-point pressure in patients with genuine stress incontinence, and to define a critical stress leak-point pressure value to detect patients with a low-pressure urethra, as defined by a maximal urethral closure pressure less than 20 cm H2O.
Fifty-nine patients with genuine stress incontinence were evaluated prospectively with multichannel urodynamics. Maximal urethral closure pressures and stress leak-point pressures were determined and correlated. Several stress leak-point pressure values were evaluated by contingency tables to detect a critical level for detecting a low-pressure urethra.
There is a statistically significant relationship (P < .0001) between the stress leak-point pressure and the maximal urethral closure pressure. However, a correlation coefficient of 0.56 demonstrates poor clinical relationship. A stress leak-point pressure less than or equal to 45 cm H2O was found to be 80% sensitive and 90% specific in diagnosing a low-pressure urethra. A stress leak-point pressure less than or equal to 60 cm H2O was 90% sensitive and 64% specific in detecting a low-pressure urethra.
The stress leak-point pressure has poor clinical correlation to the maximal urethral closure pressure. A stress leak-point pressure less than or equal to 45 cm H2O has adequate sensitivity and specificity to diagnose a low-pressure urethra. A value less than or equal to 60 cm H2O would be an appropriate cutoff level to screen for those patients at risk of having a low-pressure urethra in need of further evaluation.
确定真性压力性尿失禁患者最大尿道闭合压与压力性漏尿点压之间的相关性，并定义一个临界压力性漏尿点压值，以检测最大尿道闭合压小于20 cm H₂O所定义的低压尿道患者。
对59例真性压力性尿失禁患者进行前瞻性多通道尿动力学评估。测定最大尿道闭合压和压力性漏尿点压并进行相关性分析。通过列联表评估几个压力性漏尿点压值，以检测出检测低压尿道的临界水平。
压力性漏尿点压与最大尿道闭合压之间存在统计学显著关系（P <.0001）。然而，相关系数为0.56表明临床关系较差。发现压力性漏尿点压小于或等于45 cm H₂O在诊断低压尿道时敏感性为80%，特异性为90%。压力性漏尿点压小于或等于60 cm H₂O在检测低压尿道时敏感性为90%，特异性为64%。
压力性漏尿点压与最大尿道闭合压的临床相关性较差。压力性漏尿点压小于或等于45 cm H₂O在诊断低压尿道时有足够的敏感性和特异性。小于或等于60 cm H₂O的值将是一个合适的截断水平，用于筛查有低压尿道风险且需要进一步评估的患者。
