A comparison of urethral pressure profilometry using microtip and double-lumen perfusion catheters in women with genuine stress incontinence.

OBJECTIVE

To compare urethral pressure profilometry measurements using microtip transducer and double-lumen perfusion catheters.

DESIGN

Prospective study.

SETTING

Tertiary referral urogynaecology unit.

SAMPLE: Three hundred and ninety two non-pregnant women with various lower urinary tract symptoms.

METHODS

Multichannel urodynamic investigations were performed using double-lumen perfusion catheters with external pressure transducers in 392 women. For those 301 (76.8%) diagnosed as having genuine stress incontinence, an investigation with microtip transducers followed. For data analysis, a mixed-effects model was used to evaluate changes in the urethral profilometry and an approach proposed by Bland and Altman was applied to access agreement between the two techniques.

RESULTS

Of the 301 women with genuine stress incontinence, 272 were eligible for this study. In resting status, the differences between the two techniques were statistically significant (48.9cm H2O vs 73.4cm H2O, P = 0.0001) after adjusting for age. Moreover, the agreement study also confirmed that these two techniques do not agree sufficiently.

CONCLUSION

Maximum urethral closure pressure obtained from the double-lumen catheter was significantly higher than that obtained from the microtip catheter. Use of the double-lumen catheter for the measurement of maximum urethral closure pressure can be considered a reliable technique since its reproducibility is as good as that of the microtip catheter. Therefore, the diagnosis of 'low pressure urethra' will be different between the two techniques.