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Int Neurourol J > Volume 5(2); 2001 > Article
Clinical Investigation
Journal of the Korean Continence Society 2001;5(2): 57-63.
Difference of Cough and Valsalva Maneuvers in the Dynamic Testing of Stress Urinary Incontinence.
Dong Deuk Kwon, Seung Il Jung, Bong Ryoul Oh, Kwang Sung Park, Soo Bang Ryu, Yang Il Park
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
The aim of the study was to evaluate the relationship between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP) in the patients with stress incontinence and to determine the correlation between maximal urethral closure pressure(MUCP) and leak point pressure.
Thirty women with stress urinary incontinence were included. Two women were excluded from the evaluation because of detrusor instability. At the bladder volume of 200-300ml cough leak-point pressure and Valsalva leak-point pressure were measured in the sitting position by using 8Fr intravesical catheter.
Valsalva leak-point pressure was significantly lower than cough leak-point pressure (69.4+/-24.5 versus 86.6+/-28.1cmH2O, p<0.0001). If intrinsic sphincter deficiency was defined as a leak-point pressure of 60cmH2O or less, 21.4% of women fulfilled this criterion using the cough leak-point pressure compared to 42.8% if the Valsalva leak-point pressure is used. Valsalva leak-point pressure and maximal urethral closure pressure were statistically correlated (p<0.05). However, a correlation coefficient of 0.38 demonstrated poor clinical relationship.
Cough leak-point pressures were significantly higher than Valsalva leak-point pressures. Cough and Valsalva maneuvers seem to result in a different reaction of the pelvic floor. Valsalva leak-point pressure has more statistical correlation to the maximal urethral closure pressure than cough leak-point pressure. So Valsalva leak-point pressure may have a additional benefit for detecting type III stress urinary incontinence. However, variations in Valsalva leak-point pressure measurement must be precisely descibed, standardized, and validated before a technique can be advocated for clinical use.
Keywords: Cough leak-point pressure; Valsalva leak-point pressure; Maximal urethral closure pressure; Stress incontinence
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Official Journal of Korean Continence Society & ESSIC (International Society for the Study of BPS) & Korean Society of Urological Research & The Korean Children’s Continence and Enuresis Society & The Korean Association of Urogenital Tract Infection and Inflammation & Korean Society of Geriatric Urological Care
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