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Cited by 102Pelvic floor disorders treatmentsUrinary Bladder and Prostate ResearchSexual function and dysfunction studies

The DOI matches its Crossref record, with a small difference in title or year; 15 of the 15 references it cites were found in a registry or an index.

Diagnosing intrinsic sphincteric deficiency: Comparing urethral closure pressure, urethral axis, and Valsalva leak point pressures

Bump, Richard C., Coates, Kimberly W., Cundiff, Geoffrey W., Harris, Robert L., Weidner, Alison C.·1997·American Journal of Obstetrics and Gynecology
DOI 10.1016/s0002-9378(97)70191-1
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Abstract

Objectives Our purpose was to compare three measures proposed to diagnose intrinsic sphincteric deficiency: maximum urethral closure pressure, Valsalva leak point pressure, and straining urethral axis.Study design A total of 159 women with pure genuine stress incontinence had the three measures determined in a standardized fashion. Critical cutoff values for the Valsalva leak point pressure (52 cm) and urethral axis (22 degrees) were established by examining relative frequency distribution curves, using closure pressure of 20 as the arbitrary benchmark value for the prevalence of intrinsic sphincteric deficiency. The distribution of cutoff values is described and differences among the measures with respect to risk factors for intrinsic sphincteric deficiency and incontinence severity were determined.Results Half the subjects fell below at least one cutoff value, but only 10% fell below all three. Sixty-four percent of subjects with either low closure pressure or leak point pressure had low values for the other, whereas 21% had discordance between them. Only 53% of subjects with low closure pressure and 40% with low leak point pressure had an axis < or = 22 degrees. Conversely, a substantial portion (36%) of subjects with pure genuine stress incontinence without urethral hypermobility had neither low urethral or leak point pressures. All three cutoff-values were associated with risk factors for intrinsic sphincteric deficiency, but only low closure and leak point pressures had significant associations with the severity of incontinence.Conclusions Intrinsic sphincteric deficiency should be diagnosed by a composite of historic, urodynamic, anatomic, and clinical severity criteria. We would include a maximum urethral closure pressure < or = 20, a Valsalva leak point pressure < or = 50, and a stress urethral axis < or = 20 in this composite.

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Crossref · 10.1016/s0002-9378(97)70191-1

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15 of 15 references verified0 citation errors · 0 not checkable

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  • Recurrence was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system validated by the International Continence Society.

    “Staging of the apical prolapse was done using the Pelvic Organ Prolapse Quantification (POP-Q) system validated by the International Continence Society (ICS) into stages I, II, III, and IV in the lithotomy position under maximal strain [21,22].”

    From Recurrence Rate and Risk Factors for Apical Prolapse After Sacrospinous Ligament Fixation: A Prospective Cohort Study (2026) · cites this paper as [21]

Citations

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Research works printed but not linked: 9

  1. Haab, 1996, Female stress urinary incontinence due to intrinsic sphincteric deficiency: recognition and management, JUrol, 156, 3
  2. McGuire, 1981, Diagnostic advantages of fluoroscopic monitoring during urodynamic evaluation, JUrol, 125, 830
  3. McGuire, 1993, Clinical assessment of urethral sphincter function, JUrol, 15, 1452
  4. Sand, 1987, The low pressure urethra as a factor in failed retropubic urethropexy, Obstet Gynecol, 69, 399
  5. Wyman, 1988, The urinary diary in evaluation of incontinence in women: a test-retest analysis, Obstet Gynecol, 71, 812
  6. Abrams, 1988, The International Continence Society Committee on Standardisation of Terminology: the standardisation of terminology of lower urinary tract function, Scand JUrol Nephrol, 1145, 5
  7. Horbach, 1988, A suburethral sling procedure with polytetrafluoroethylene for the treatment of genuine stress incontinence in patients with low urethral closure pressure, Obstet Gynecol, 71, 648
  8. Horbach, 1994, Predicting intrinsic urethral sphincter dysfunction in women with stress urinary incontinence, Obstet Gynecol, 84, 188
  9. Bergman, 1989, Negative Q-tip test as a risk factor for failed incontinence surgery in women, J Reprod Med, 37, 193

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Metadata

Authors
Bump, R. C., Coates, K. W., Cundiff, G. W., Harris, R. L., & Weidner, A. C.
Affiliations
Duke Medical Center (US)
ORCID
Cundiff, Geoffrey W.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
1997-08
Volume
177
Issue
2
Pages
303-310
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/s0002-9378(97)70191-1
OpenAlex
W2126769401
Cited by
102
References
15
Citations by year
2026: 2 · 2024: 2 · 2023: 1 · 2021: 1 · 2020: 1 · 2018: 1 · 2017: 2 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 3
FWCI
3.00
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
intrinsic sphincteric deficiency, stress urinary incontinence, urethral closure pressure, Valsalva leak point pressure, urethral hypermobility, diagnostic thresholds, incontinence severity, risk factors, women
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Urethra, Urinary Incontinence, Stress, Urodynamics, Valsalva Maneuver

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