여성복압성 요실금환자에서 Valsava Leak Point Pressure와 증상정도의 상관관계

Abstract

Purpose: The Valsalva leak point pressure testing is a valuable tool in the diagnosis of female stress urinary incontinence, especially intrinsic sphincter deficiency. The purpose of this study is to correlate clinical parameters of stress urinary incontinence with Valsalva leak point pressure which represents intrinsic sphincter activity. Materials and Methods: We examined sixty consecutive women with stress urinary incontinence including symptom grade(SEAPI-QMN classification), Q-tip test, 1 hour pad test and Valsalva leak point pressure. The clinical parameters of stress urinary incontinence were compared each other and the correlation coefficients were analyzed between them. Results: The mean patient age was 50 years(range 27 to 75 years). Their symptom grade was grade 1 in 17 patients (28.3%), 2 in 30 (50%) and 3 in 13 (22.7%). According to Blaivas and Olsson classification, they were type Ⅰ in 10 patients (16.7%), Ⅱ in 43 (71.7%) and Ⅲ in 7 (12.6%). The patients who have Valsalva leak point pressure of greater than 60cm. water and the urethral hypermobility were grade 1 in 17 patients (100%) and 14 patients (82.4%), 2 in 28 (93.3%) and 26 (86.7%), 3 in 4 (30.8%) and 7(53.8%). There was a statistically significant difference between the number of patients with Valsalva leak point pressure of greater than 60cm. water and 60cm. water or less among the 3 symptom grades (p<0.01). The Valsalva leak point pressure in patients with urethral hypermobility was significantly higher than in those without urethral hypermobility (p<0.05). The Valsalva leak point pressure was highly correlated with the symptom grades among clinical parameters of stress urinary incontinence. Conclusion: Women with higher symptom grades of stress urinary incontinence were significantly more likely to have a low Valsalva leak point pressure which indicate intrinsic sphincter deficiency.