Objective assessment of the severity of stress urinary incontinence by urodynamic tests and introital ultrasound

ABSTRACT

To determine whether objective differences exist in the results of urodynamic tests and introital ultrasonography between patients with grade 1 and 2 stress urinary incontinence. The study included fifty premenopausal women with the diagnosis of stress urinary incontinence as proved by urodynamic findings [cystometric exclusion of detrusor hyperactivity]. Patients were classified into grade 1 and 2 according to the degree of physical activity required to produce urinary leakage. Twenty five patients had grade 1 and 25 had grade 2 stress urinary incontinence. Parameters of uroflowmetry filling crystometry, urethral pressure profile and introital ultrasound were compared between grade 1 and 2 stress urinary incontinence. Urodynamic measurements showed that in uroflowmetry, there were no significant differences in maximum flow rate or residual urine between grade 1 and 2. In Filling crystometry, there were no significant differences in the first desire to void or maximum cystometric capacity between the two groups. There were also no significant differences in any of the urethral pressure profile parameters. Intorital ultrasound revealed no significant differences in posterior urethrovesical angle, bladder neck descent or urethral funneling between grade 1 and 2. There are no differences in objective related parameters between patients with grade 1 and 2 stress urinary incontinence, as documented by both urodynamic and ultrasound studies. The development of more objective tests as 3D ultrasound, ultrasound with contrast media, color Doppler and MRI is required to accurately classify stress urinary incontinence