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“ While historically it has been helpful to categorize SUI, particularly when choosing an appropriate intervention, it must be remembered that these are simplistic/arbitrary concepts which belittle the complex nature of the underlying pathophysiology.
The majority of women will have varying amounts of urethral hypermobility and ISD combined with varying degrees of pelvic floor weakness and prolapse.
Unfortunately, there remains little consensus on how best to define ISD and urethral hypermobility and how to accurately assess them .”
ICS : Dysfunctional voiding is an intermittent and / or fluctuating flow rate due to involuntary intermittent contractions of peri-urethral striated muscle during voiding in neurologically normal patients
Male : 35% of bladder outlet obstruction especially in young adults
Khuo HC . Videourodynamic analysis of pathophysiology of men with both storage and voiding lower urinary tract symptoms.Urology 2007;70:272-6
Female : common in painful bladder and related pelvic floor syndromes
Kim SH,KimTB,Kim SW et a .Urodynamic findings of the painful bladder syndrome/interstitial cystitis : a comparison with idiopathic overactive bladder.J Urol 2009;181:2550-4
Gold Standard : Pressure / Flow & EMG
Office Urodynamics : Intermittent flow &
MUCP Female : excedent 10 cmH20 age - dependent value
MUCP Male : excedent 10 cm H20 a fixed value of 120 cm H20
Porena M ,Mearini E,Mearini L .Giannantoni A. Voiding disfunction after readical retropubic prostatectomy: more than external urethral sphincter mechanism.Eur Urol 2007; 52:38-45
Quantification of sphincteric damage important (balloons , sling surgery)
MUCP more reliable than VLPP
Comiter C ,Sullivan M,Yalla S .Correlation among maximal urethral closure pressure, retrograde leak point pressure and abdominal leak point pressure in men with postprostatectomy stress incontinence. Urology 2003 ;62:75-8
Kielb S , Clemens J Comprehensive urodynamics evaluation of 146 men after radical prostatectomy , Urology 2005;66:392-396
MUCP between 60 and 80 cm H20 mild sphincteric weakness,
MUCP between 40 and 60 cm H20 moderate sphincteric weakness