Association of baseline urodynamic measures of urethral function with clinical, demographic, and other urodynamic variables in women prior to undergoing midurethral sling surgery
Toby C Chai, Liyuan Huang, Kim Kenton, Holly E Richter, Jan Baker, Stephen Kraus, Heather Litman, Urinary Incontinence Treatment Network (UITN), Elizabeth A Gormley, Larry Sirls, Salil Khandwala, Linda Brubaker, Kimberly Kenton, Holly E Richter, L Keith Lloyd, Michael Albo, Charles Nager, Toby C Chai, Harry W Johnson, Halina M Zyczynski, Wendy Leng, Philippe Zimmern, Gary Lemack, Stephen Kraus, Thomas Rozanski, Peggy Norton, Ingrid Nygaard, Sharon Tennstedt, Anne Stoddard, Debuene Chang, John Kusek, Rebekah Rasooly, Amy Arisco, Jan Baker, Diane Borello-France, Kathryn L Burgio, Ananias Diokno, MaryPat Fitzgerald, Chiara Ghetti, Patricia S Goode, Robert L Holley, Yvonne Hsu, Margie Kahn, Jerry Lowder, Karl Luber, Emily Lukacz, Alayne Markland, Shawn Menefee, Pamela Moalli, Elizabeth Mueller, Leslie Rickey, Elizabeth Sagan, Joseph Schaffer, Robert Starr, Gary Sutkin, R Edward Varner, Emily Whitcomb, Laura Burr, JoAnn Columbo, Tamara Dickinson, Rosanna Dinh, Judy Gruss, Alice Howell, Chaandini Jayachandran, Kathy Jesse, Lynn Kalinoski, Barbara Leemon, Karen Mislanovich, Elva Kelly Moore, Caren Prather, Jennifer Tabaldo, Tia Thrasher, Mary Tulke, Robin Willingham, Kimberly Woodson, Gisselle Zazueta-Damian, Kathleen Cannon, Kimberly J Dandreo, Liyuan Huang, Rose Kowalski, Heather Litman, Marina Mihova, Anne Stoddard, Kerry Tanwar, Sharon Tennstedt, Yan Xu, J Quentin Clemens, Paul Abrams, Deidre Bland, Timothy B Boone, John Connett, William Henderson, Sheryl Kelsey, Deborah J Lightner, Deborah Myers, Bassem Wadie, J Christian Winters, Toby C Chai, Liyuan Huang, Kim Kenton, Holly E Richter, Jan Baker, Stephen Kraus, Heather Litman, Urinary Incontinence Treatment Network (UITN), Elizabeth A Gormley, Larry Sirls, Salil Khandwala, Linda Brubaker, Kimberly Kenton, Holly E Richter, L Keith Lloyd, Michael Albo, Charles Nager, Toby C Chai, Harry W Johnson, Halina M Zyczynski, Wendy Leng, Philippe Zimmern, Gary Lemack, Stephen Kraus, Thomas Rozanski, Peggy Norton, Ingrid Nygaard, Sharon Tennstedt, Anne Stoddard, Debuene Chang, John Kusek, Rebekah Rasooly, Amy Arisco, Jan Baker, Diane Borello-France, Kathryn L Burgio, Ananias Diokno, MaryPat Fitzgerald, Chiara Ghetti, Patricia S Goode, Robert L Holley, Yvonne Hsu, Margie Kahn, Jerry Lowder, Karl Luber, Emily Lukacz, Alayne Markland, Shawn Menefee, Pamela Moalli, Elizabeth Mueller, Leslie Rickey, Elizabeth Sagan, Joseph Schaffer, Robert Starr, Gary Sutkin, R Edward Varner, Emily Whitcomb, Laura Burr, JoAnn Columbo, Tamara Dickinson, Rosanna Dinh, Judy Gruss, Alice Howell, Chaandini Jayachandran, Kathy Jesse, Lynn Kalinoski, Barbara Leemon, Karen Mislanovich, Elva Kelly Moore, Caren Prather, Jennifer Tabaldo, Tia Thrasher, Mary Tulke, Robin Willingham, Kimberly Woodson, Gisselle Zazueta-Damian, Kathleen Cannon, Kimberly J Dandreo, Liyuan Huang, Rose Kowalski, Heather Litman, Marina Mihova, Anne Stoddard, Kerry Tanwar, Sharon Tennstedt, Yan Xu, J Quentin Clemens, Paul Abrams, Deidre Bland, Timothy B Boone, John Connett, William Henderson, Sheryl Kelsey, Deborah J Lightner, Deborah Myers, Bassem Wadie, J Christian Winters
Abstract
Aims: To explore how baseline demographic, clinical, and urodynamic (UDS) variables correlate with measures of urethral function in women planning midurethral sling surgery.
Methods: Women with predominant stress urinary incontinence (SUI) as part of the trial of mid-urethral slings (TOMUS) were characterized preoperatively including: demographics, body mass index (BMI), responses to the Medical and Epidemiologic Social Aspects of Aging (MESA) and Urogenital Distress Inventory (UDI) questionnaires, pad weight (PW), incontinence duration, prior SUI surgery, prolapse, strength of pelvic contraction, Q-tip test, uroflow, cystometrogram, and detrusor pressures at maximum flow (Pdet at Qmax). Multivariate regression analysis and modeling confirmed variables with significant correlations with maximal urethral closure pressure (MUCP), functional urethral length (FUL), and Valsalva leak point pressure (VLPP).
Results: Five-hundred thirty-nine women were included in the analysis. In multivariable analyses, PW (P = 0.045) and age (P < 0.0001) were negatively correlated with MUCP (as PW and age increased, MUCP decreased); BMI (P = 0.02) and Pdet at Qmax (P < 0.0001) were positively correlated with MUCP (as BMI and Pdet at Qmax increased, MUCP increased). Age (P = 0.002) was negatively correlated with FUL; Qtip delta (P = 0.006), pelvic organ prolapse quantification examination (POPQ) stage (P = 0.002) and strength of pelvic contraction (P = 0.03) were positively correlated with FUL. Duration of incontinence (P = 0.01) was negatively correlated with VLPP; Qtip delta (P = 0.02), BMI (P = 0.0005) and Pdet at Qmax (P = 0.0005) were positively correlated with VLPP.
Conclusions: Age, BMI, Qtip delta, and Pdet at Qmax were variables that correlated with two or more measures of urethral function. These correlations may help direct future research in female urethral function.
Copyright © 2012 Wiley Periodicals, Inc.
Source: PubMed