Ariana L Smith1, William I Jaffe, Mary Wang, Alan J Wein. 1. Department of Surgery, Division of Urology, University of Pennsylvania School of Medicine, Perelman Center for Advanced Medicine, Philadelphia, PA 19104, USA. ariana.smith@uphs.upenn.edu
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.
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 DOincontinence 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.
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