Accuracy of cystourethrometric findings in detecting urodynamic stress incontinence in women.

Objective: To determine the most accurate of cystourethrometric parameters in detecting urodynamic stress incontinence (USI ) in women.

Methods: A case-control study was carried out in the Urodynamic Units in Aleppo University Hospitals, Aleppo, Syria, between January 2008 and June 2010. Seventy-six women suffering from either urgency, urge incontinence, stress incontinence, or mixed symptom, and attended to the urodynamic units were included in this study. Two groups were recruited, USI group (study group; n=52), who had the diagnosis of USI by the urodynamic study and non-USI group (control group; n=24), who did not have this diagnosis by urodynamic study. Comparison between the 2 groups in urodynamic findings was carried out.

Results: In the urodynamic study, maximal urethral closure pressure (MUCP) in the sitting position, transmission ratio (TR) in the sitting position, MUCP change (changing position from supine to sitting), and MUCP change% (percentage of maximal closure pressure change with position) were statistically lower in the USI group compared to control group. The most accurate parameters in detecting USI were MUCP change and MUCP change%, with a sensitivity of more than 90% and specificity of more than 70% at cut off values of ≤ 8 cm H₂O for MUCP change and ≤ 11.2% for MUCP change%. Both groups were comparable with regard to age, parity, body mass index, presence of menopause, patient's impression of the severity of incontinence, and stage of cystocyle.

Conclusion: Cystourethrometric parameters such as MUCP sitting, TR sitting, MUCP change, and MUCP change% measurement could be of value in distinguishing between USI women and non-USI women.