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Dropped abdominal pressure at void in women

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Abstract

Introduction and hypothesis

“Dropped pabd at void” occurs when pabd decreases below the previous resting pressure during voiding time. We sought clinical factors associated with this phenomenon and evaluated whether its correction modifies the urodynamic diagnosis.

Methods

Retrospective cross-sectional study of non-neurological consecutive symptomatic women. The following definitions were used: “dropped pabd at void”: decrease in pabd at Qmax ≥ 5 cmH2O; bladder outflow obstruction (BOO) (pdetQmax ≥ 25 cmH2O + Qmax ≤ 12 ml/s and female BOO index (pdetQmax – 2.2*Qmax) > 18; “low detrusor contraction strength”: PIP1 (pdetQmax + Qmax) < 30. In patients with “dropped pabd at void”, pdetQmax was corrected.

Results

A total of 360 women were analyzed. Ninety-five percent of the women had a variation in pabd at Qmax between −13 and 53 cmH2O. “Dropped pabd at void” was found in 100 women (27.8%). History of stress urinary incontinence (SUI) surgery was significantly higher (p = 0.016) and symptoms of mixed urinary incontinence were significantly lower (p = 0.030) in patients with “dropped pabd at void”. On multivariate analysis only the history of SUI surgery maintained its significance (OR = 1.787 [95% CI: 1.058, 3.017], p = 0.030). When correcting pdetQmax in women with “dropped pabd at void”, 2 or 5 patients lost BOO diagnosis (depending on how it was diagnosed) and 7 patients gained a “low detrusor contraction strength” diagnosis.

Conclusions

Approximately one-quarter of women had “dropped pabd at void”, which was associated with a history of SUI surgery. Correction of pdetQmax would lead to a 2.5% to 3.33% diagnostic modification.

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Acknowledgements

We thank Ariel Castro-Lara, MSc in Clinical Epidemiology, from the “Oficina de Apoyo a la Investigación Clínica”, Hospital Clínico Universidad de Chile, for his important assistance in the calculation of the post-hoc statistical power of the multivariate regression model.

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Authors and Affiliations

  1. Department of Urology, Hospital Clínico Universidad de Chile, Dr. Carlos Lorca Tobar 999, 8380456, Santiago, Chile

    Juan Pablo Valdevenito & Alejandro Mercado-Campero

  2. Department of Obstetrics and Gynecology, Female Pelvic Floor Unit, Hospital Clínico Universidad de Chile, Santiago, Chile

    Juan Pablo Valdevenito, Valentín Manríquez & Loreto Medina

  3. Department of Urology, Hospital Universitario de La Princesa, Madrid, España

    Luis López-Fando

  4. Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile

    Carlos Ignacio Calvo

Authors
  1. Juan Pablo Valdevenito
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  2. Alejandro Mercado-Campero
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  3. Luis López-Fando
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  4. Carlos Ignacio Calvo
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  5. Valentín Manríquez
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  6. Loreto Medina
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Contributions

J.P. Valdevenito: protocol/project development, data collection or management, data analysis, manuscript writing/editing; A. Mercado-Campero, L. López-Fando, C.I. Calvo, V. Manríquez, L. Medina: data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Juan Pablo Valdevenito.

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Conflicts of interests

J.P. Valdevenito, A. Mercado-Campero, C.I. Calvo, V. Manríquez, L. Medina: nothing to disclose. L. López-Fando: speaker’s fees from Astellas, Coloplast, Neomedic, not related to this study.

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Valdevenito, J.P., Mercado-Campero, A., López-Fando, L. et al. Dropped abdominal pressure at void in women. Int Urogynecol J 33, 3275–3281 (2022). https://doi.org/10.1007/s00192-022-05202-9

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  • DOI: https://doi.org/10.1007/s00192-022-05202-9

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