The Valsalva Urethral Profile : a Measure to Assess Stress Urinary Incontinence

NCT ID: NCT04311814

Last Updated: 2020-03-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

695 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-15

Study Completion Date

2019-12-20

Brief Summary

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Clinical and paraclinical appraisal of stress urinary incontinence (SUI) is mainly based on the assessment of pelvic floor muscles (PFM) contraction and urethral mobility, the measurement of the maximum urethral closure pressure (MUCP) at rest by urethral pressure profilometry (UPP) and the measurement of the Valsalva leak point pressure (VLPP).

Currently, MUCP and VLPP cannot be used for diagnosing SUI because they appear to be moderately correlated with the severity of SUI.

The lack of a specific SUI biomarker could be the explanation for the poor predictive value of urodynamics and the ongoing debate on whether urodynamic testing before surgery has benefits. Our main objective was to study the value of a new urodynamic parameter in the diagnosis of female SUI: the Valsalva urethral profile (VUP)

Detailed Description

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Conditions

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Stress Urinary Incontinence

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

We conducted a monocentric interventional study, carried out as part of routine care
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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v-MUCP value

All patients referred for urodynamics explorations will have a measure of the MUCP during a Valsalva manoeuver

Group Type OTHER

Maximum urethral closure pressure during Valsalva (v-MUCP)

Intervention Type DIAGNOSTIC_TEST

v-MUCP measurement was performed for all patients referred for urodynamic exploration of the lower urinary tract

Interventions

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Maximum urethral closure pressure during Valsalva (v-MUCP)

v-MUCP measurement was performed for all patients referred for urodynamic exploration of the lower urinary tract

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* women over the age of 18 years, referred for urodynamic exploration of the lower urinary tract, with or without lower urinary tract disorders (TUBA)
* women who gave their consent to participate in the study.

Exclusion Criteria

* pelvic organ prolapse (POP) ≥ stage 2 according to the POP-Q classification
* history of surgery for SUI and / or POP,
* acute urinary tract infection,
* proven neurological pathology,
* urine retention,
* a history of pneumothorax
* a lability of MUCP ≥ 15 cmH2O
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Poissy-Saint Germain Hospital

OTHER

Sponsor Role lead

Responsible Party

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Anne Cecile Pizzoferrato

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Philippe Dompeyre, MD

Role: PRINCIPAL_INVESTIGATOR

Intercommunal Hsopital center of Poissy Saint Germain

References

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Petros PE, Ulmsten UI. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl. 1993;153:1-93. No abstract available.

Reference Type BACKGROUND
PMID: 8108659 (View on PubMed)

DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol. 1994 Jun;170(6):1713-20; discussion 1720-3. doi: 10.1016/s0002-9378(94)70346-9.

Reference Type BACKGROUND
PMID: 8203431 (View on PubMed)

DeLancey JO, Trowbridge ER, Miller JM, Morgan DM, Guire K, Fenner DE, Weadock WJ, Ashton-Miller JA. Stress urinary incontinence: relative importance of urethral support and urethral closure pressure. J Urol. 2008 Jun;179(6):2286-90; discussion 2290. doi: 10.1016/j.juro.2008.01.098. Epub 2008 Apr 18.

Reference Type BACKGROUND
PMID: 18423707 (View on PubMed)

Bump RC, Elser DM, Theofrastous JP, McClish DK. Valsalva leak point pressures in women with genuine stress incontinence: reproducibility, effect of catheter caliber, and correlations with other measures of urethral resistance. Continence Program for Women Research Group. Am J Obstet Gynecol. 1995 Aug;173(2):551-7. doi: 10.1016/0002-9378(95)90281-3.

Reference Type BACKGROUND
PMID: 7645634 (View on PubMed)

McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA. Clinical assessment of urethral sphincter function. J Urol. 1993 Nov;150(5 Pt 1):1452-4. doi: 10.1016/s0022-5347(17)35806-8.

Reference Type BACKGROUND
PMID: 8411422 (View on PubMed)

Theofrastous JP, Bump RC, Elser DM, Wyman JF, McClish DK. Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence. The Continence Program for Women Research Group. Am J Obstet Gynecol. 1995 Aug;173(2):407-12; discussion 412-4. doi: 10.1016/0002-9378(95)90260-0.

Reference Type BACKGROUND
PMID: 7645615 (View on PubMed)

Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996 Jul;175(1):10-7. doi: 10.1016/s0002-9378(96)70243-0.

Reference Type BACKGROUND
PMID: 8694033 (View on PubMed)

Kirschner-Hermanns R, Anding R, Rosier P, Birder L, Andersson KE, Djurhuus JC. Fundamentals and clinical perspective of urethral sphincter instability as a contributing factor in patients with lower urinary tract dysfunction--ICI-RS 2014. Neurourol Urodyn. 2016 Feb;35(2):318-23. doi: 10.1002/nau.22815.

Reference Type BACKGROUND
PMID: 26872575 (View on PubMed)

Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-30. doi: 10.1002/nau.20041.

Reference Type BACKGROUND
PMID: 15227649 (View on PubMed)

Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C, Laycock J, Lim PH, van Lunsen R, a Nijeholt GL, Pemberton J, Wang A, Watier A, Van Kerrebroeck P. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn. 2005;24(4):374-80. doi: 10.1002/nau.20144. No abstract available.

Reference Type BACKGROUND
PMID: 15977259 (View on PubMed)

Fritel X, Fauconnier A, Bader G, Cosson M, Debodinance P, Deffieux X, Denys P, Dompeyre P, Faltin D, Fatton B, Haab F, Hermieux JF, Kerdraon J, Mares P, Mellier G, Michel-Laaengh N, Nadeau C, Robain G, de Tayrac R, Jacquetin B; French College of Gynaecologists and Obstetricians. Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol. 2010 Jul;151(1):14-9. doi: 10.1016/j.ejogrb.2010.02.041. Epub 2010 Mar 16.

Reference Type BACKGROUND
PMID: 20236751 (View on PubMed)

Nager CW, Schulz JA, Stanton SL, Monga A. Correlation of urethral closure pressure, leak-point pressure and incontinence severity measures. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):395-400. doi: 10.1007/s001920170020.

Reference Type BACKGROUND
PMID: 11795644 (View on PubMed)

Pizzoferrato AC, Fauconnier A, Fritel X, Bader G, Dompeyre P. Urethral Closure Pressure at Stress: A Predictive Measure for the Diagnosis and Severity of Urinary Incontinence in Women. Int Neurourol J. 2017 Jun;21(2):121-127. doi: 10.5213/inj.1732686.343. Epub 2017 Jun 21.

Reference Type BACKGROUND
PMID: 28673060 (View on PubMed)

Dietz HP, Clarke B. The urethral pressure profile and ultrasound imaging of the lower urinary tract. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(1):38-41. doi: 10.1007/s001920170092.

Reference Type BACKGROUND
PMID: 11294530 (View on PubMed)

Other Identifiers

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2015-A01411-48

Identifier Type: -

Identifier Source: org_study_id

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