E Urethral Pressure Profile Overview

Sufficient urethral pressure is mandatory for the maintenance of urinary incontinence. Urethral profile measurement (or urethral profilometry) is a technique used to record the intraluminal pressure changes within the entire length of the urethra. A satisfactory evaluation of urethral function can be made by a standard filling/voiding bladder urodynamic study, such that urethral closure mechanism is considered adequate if no incontinence is demonstrated and inadequate if there is obvious stress leakage. Demonstration of urinary stress leakage therefore represents a direct assessment of urinary incontinence, while urethral pressure profilometry (UPP) is a less direct method.

In clinical practice, because UPP has been plagued with inconsistencies and remains susceptible to artifactual errors, it offers little to patient management and does not enjoy widespread usage. The discussion in this chapter therefore will be limited to basic principles.

• Maximum urethral profile (MUP)—highest pressure recorded on the pressure profile

• Maximum urethral closure pressure (MUCP)—difference between the MUP and intravesical pressure

• Functional profile length (FPL)—length of urethra along which the urethral pressure exceeds intravesical pressure

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