The clinical value of ambulatory urethral pressure recording in women

The value of ambulatory urethral pressure recording (AUPR) was evaluated by reviewing both data from 116 patients investigated and Ambulatory Urodynamic Monitoring (AUM) tracings. Typical tracings are shown from conditions where we find that AUPR is of value. (i) Stress incontinence where a patient who complains of stress incontinence does not leak during the stress test, but leaks while jumping on a trampoline. (ii) Mixed incontinence--in only 43% of patients complaining of both urge ands stress incontinence mixed incontinence was documented by AUM. Thirty-six per cent of patients complaining of both urge and stress incontinence were found to be stress incontinent and 21% were leaking due to an unstable detrusor. (iii) Urethral closure pressure of 20 cmH2O or less (low urethral closure pressure; LUCP). LUCP was found in 13% of the patients. Patients with LUCP may leak due to stress, unstable detrusor or unstable urethra. We conclude that ambulatory recording of both urethral and bladder pressures in addition to leakage may contribute to a more complete diagnosis and treatment in these conditions.