The Urethral Pressure Profile and Ultrasound Imaging of the Lower Urinary Tract

2001 ◽  
Vol 12 (1) ◽  
pp. 38-41 ◽  
Author(s):  
H. P. Dietz ◽  
B. Clarke
2020 ◽  
Vol 24 (1) ◽  
pp. 52-58
Author(s):  
Chin-Jui Wu ◽  
Wan-Hua Ting ◽  
Ho-Hsiung Lin ◽  
Sheng-Mou Hsiao

Purpose: The Q-tip test is used to measure urethral hypermobility and can predict surgical outcomes. However, certain factors may affect the reliability of this test. Our aim was to identify independent clinical and urodynamic predictors of the results of the Q-tip test.Methods: Between January 2014 and June 2019, 176 consecutive women with lower urinary tract symptoms who underwent the Q-tip test and urodynamic studies were included in this retrospective study.Results: Multivariable regression analysis revealed that age (regression coefficient, -0.55), point Ba (regression coefficient, 4.1), urodynamic stress incontinence (regression coefficient, 9.9), maximum flow rate (Qmax) (regression coefficient, 0.13), pressure transmission ratio (PTR) at maximum urethral pressure (MUP) (regression coefficient, -0.14), and the score on the fifth question of the Incontinence Impact Questionnaire (IIQQ5; “Has urine leakage affected your participation in social activities outside your home?”; regression coefficient, -4.1) were independent predictors of the Q-tip angle, with a constant of 87.0. The following Spearman rank correlation coefficients were found between the Q-tip angle and the following variables: age, -0.38; point Ba, 0.34; urodynamic stress incontinence, 0.32; Qmax, 0.28; PTR at MUP, -0.28; and IIQQ5, -0.23. A receiver operating characteristic curve (ROC) analysis for the prediction of urodynamic stress incontinence found that the optimum cutoff for PTR at MUP was <81%, with an area under the ROC curve of 0.70.Conclusions: Age, point Ba, urodynamic stress incontinence, Qmax, PTR at MUP, and IIQQ5 were independent predictors of the Q-tip angle. However, none of these could be used as effective surrogates for the Q-tip test due to their lack of a sufficient correlation.


Author(s):  
Julie Ellis Jones ◽  
Hashim Hashim

Urodynamic studies encompass several tests to investigate the hydrodynamics of the lower urinary tract during bladder storage/filling and voiding. These tests include bladder diaries, free uroflowmetry, and post-void residuals, filling cystometry, voiding pressure/flow studies, urethral pressure profiles, leak point pressures, videourodynamics, ambulatory urodynamics, and electromyography. The tests are performed after formulating a urodynamics question to objectively observe lower urinary tract function and dysfunction with the idea of choosing an appropriate treatment for the pathology. Invasive urodynamic tests require appropriate training, as per the joint statement on minimum standards for urodynamic practice in the United Kingdom, and should be performed according to the International Continence Society good urodynamics practice guidelines. It is also important to be able to interpret the traces appropriately and troubleshoot any problems occurring during the test.


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