Evaluation of urethral pressure profilometry for the diagnosis of genuine stress incontinence

Summary Given the expense of radiographic imaging facilities and the reproducibility of urethral pressure measurements with microtransducers, the use of urethral pressure profilometry (UPP) has been gaining widespread popularity for the diagnosis of genuine stress incontinence (GSI). However, the clinical usefulness of the technique has not been adequately evaluated against the best available technique, namely videocystourethrography. Using the latter technique as the Gold Standard, the UPP results of 114 normal women and 95 GSI patients have been compared. In order to determine the most diagnostic UPP measure, 25 parameters were examined for each patient. With the use of the Kappa statistic it was found that the area under the stress profile was the most discriminatory of the UPP parameters. Even using this measure, the overlap between normal and GSI is so great as to make accurate diagnosis impossible. It is therefore concluded that UPP is useless for the diagnosis of GSI.