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Does uroflow predict ISD?

Phillip P Smith1, Rodney A Appell

  • 1Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA. ppsmith@bcm.tmc.edu.

Neurourology and Urodynamics
|June 28, 2007
PubMed
Summary
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Voiding flow rates do not predict intrinsic sphincteric deficiency (ISD) in women with symptomatic pelvic organ prolapse (POP). Abnormal flow rates were not reliably linked to low abdominal leak point pressure in this patient group.

Area of Science:

  • Urology
  • Female Pelvic Medicine

Background:

  • Superflow, characterized by high urinary flow rates in women, has been associated with intrinsic sphincteric deficiency (ISD), a condition linked to low urethral pressure.
  • Pelvic organ prolapse (POP) can compromise the urethral sphincteric mechanism.
  • The relationship between voiding dynamics and ISD in women with POP requires further investigation.

Purpose of the Study:

  • To determine if voiding flow rates can predict intrinsic sphincteric deficiency (ISD) in women experiencing symptomatic pelvic organ prolapse (POP).

Main Methods:

  • A retrospective review of 82 patients undergoing surgical repair for symptomatic vaginal prolapse.
  • Comparison of uroflow and urodynamic parameters between continent and stress incontinent patients.
  • Evaluation of correlations between abdominal leak point pressure (LPP) and pressure/flow data.

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Main Results:

  • Patients with urodynamic stress incontinence (SUI) exhibited higher flow rates compared to continent patients.
  • No significant difference in voided volumes was observed between uroflow and urodynamics.
  • Abdominal leak point pressure did not significantly correlate with uroflow or urodynamic pressure/flow parameters.

Conclusions:

  • Voiding flow rates, assessed via uroflow or urodynamics, are not predictive of ISD as defined by low abdominal leak point pressure in women with symptomatic POP.
  • The complex, potentially non-linear relationship between ISD and flow rates may explain the lack of correlation.
  • Abdominal leak point pressure may not be an adequate measure for defining ISD in this context.