PubMed Health⌕ Search

Biomedical subjects

H Siltberg

Publications and source records attributed to H Siltberg.

6 recordsLinked to original sources
PubMed1999

Validation of cough-induced leak point pressure measurement in the evaluation of pharmacological treatment of stress incontinence.

To improve routines in clinical practice and research, it is important that new tests are thoroughly evaluated before they gain widespread application. This includes establishing the reliability and validity of the new test. The purpose of this study was to establish the construct and criterion validity of cough-induced leak point pressure (CILPP) measurement. Data on CILPP, maximum urethral pressure (MUP), and a short-term pad test from a phase-I trial of a new pharmacological agent (LS 4416), developed for the treatment of stress incontinence, was used to test the validity of CILPP. Fifteen post-menopausal women with stress incontinence were studied. Phenylpropanolamine (PPA) was used as a positive control. Administration of PPA produced a statistically significant increase in MUP and CILPP. There was a significantly better effect of treatment, expressed as an increase in MUP at 1.5 hr, when PPA was used than with placebo or LS 4416. When CILPP was used to detect change after therapy, PPA produced a significantly greater increase in CILPP than did placebo (least square mean of difference 17.25, P = 0.0202). There was a moderate but statistically significant correlation between CILPP and the short-term Pad Test. Construct validity was demonstrated by the ability of CILPP to detect limited improvement in patients with stress incontinence. Criterion validity was established by the correlation of CILPP to a short-term Pad Test. We propose that, thanks to its greater methodological qualities, leak point pressure measurement should be adopted as a standard method to ascertain the effect of treatment in patients with stress incontinence. Neurourol. Urodynam. 18:591-602, 1999.

Aged↗
PubMed1998

Cough-induced leak-point pressure--a valid measure for assessing treatment in women with stress incontinence.

BACKGROUND: Presently available urodynamic methods are of little use for assessing the severity of urinary stress incontinence or for evaluating of treatment, Cough-induced leak-point pressure may prove to be a more useful urodynamic method in these respects. A vaginal anti-incontinence device was used to validate this new urodynamic method. AIM: The primary aim was to determine the extent to which cough-induced leak-point pressure was affected by the vaginal device. Secondary aims were to study the short-term effects of the vaginal device on leakage and urinary flow, and to relate the change in cough-induced leak-point pressure to the change in leakage as expressed by a short-term pad test. METHODS: In a prospective study of 22 women with a history of stress incontinence, the effect of a new vaginal anti-incontinence device (Conveen Continence Guard) on cough-induced leak-point pressure, a short-term pad test and urinary flow was studied. RESULTS: Cough-induced leak-point pressure increased from 99.9 to 138.9 cm H2O, while leakage, measured by a short-term pad test, decreased from 22.7 to 3.3 g when using the device. Urinary flow was not significantly reduced by the device. CONCLUSIONS: Cough-induced leak-point pressure is a valid, quantitative, dynamic measure of urethral closure function which can be used to study the effects of treatment in patients with stress incontinence. The vaginal device is effective for treatment of stress incontinence in the short-term, without reducing urinary flow.

Adult↗
PubMed1997

Frequency/volume chart: the basic tool for investigating urinary symptoms.

BACKGROUND: This article reviews the literature on the frequency/volume chart. The frequency/volume chart is the systematic registration of point of time of voiding and voided volume done by the patient in her own environment for a specified period of time, usually 24 or 48 hours. The chart can be supplemented with the registration of incontinence episodes. Measurements obtained from the frequency/volume chart include total voided volume/24 hours, frequency of micturition, mean voided volume, largest single voided volume and range of voided volumes. RESULTS: Normal values for these measurements as well as values for patients with stress incontinence and detrusor instability are presented. CONCLUSIONS: The frequency/volume chart is a simple and inexpensive way of recording basic data, some of which can be obtained in no other way, e.g. total voided volume. The frequency/ volume chart has acceptable reproducibility but limited diagnostic capacity. It provides a basis for instituting treatment in many patients and provides the best tool for following the result of treatment in patients with the urge syndrome.

Adult↗
PubMed1997

Pad weighing tests: the best way to quantify urine loss in patients with incontinence.

This article reviews the literature on pad weighing tests composed to measure urinary incontinence. The tests can be divided into short-term tests (one to two hours) performed in a clinic or laboratory, or long-term tests (12 to 48 hours) performed by the patient at home. The short-term tests, apart from practical disadvantages, have low negative predictive value and require retrograde filling of the bladder to reach acceptable reproducibility. The long-term tests have practical advantages, better sensitivity and acceptable reproducibility. Pad weighing tests have no value for the purpose of differential diagnosis. The validity of the long-term test as a measure of the symptom of urinary incontinence is obvious whereas it is unclear what the short-term test measures.

Female↗
PubMed1996

Reproducibility of a new method to determine cough-induced leak-point pressure in women with stress urinary incontinence.

The aim of the study was to test the reproducibility of a new method of determining cough-induced leak-point pressure (CILPP). A cough-induced increased in intra-abdominal pressure was recorded vaginally in 26 women with stress incontinence and urinary leakage was detected electronically. CILPP determinations and short-term pad tests were carried out on two different occasions. Reproducibility is expressed by a coefficient of repeatability as limits of agreement. These indicate that, for 95% of the cases, a repeat measurement of CILPP will be between 0.72 and 1.28 times the first measurement. The coefficient of variation was 11.2%. There was a moderate inverse correlation between pad-test data and CILPP. It was concluded that the new method allows for an accurate determination of CILPP, which represents a quantitative and dynamic assessment of urethral function. The reproducibility of the method appears to be better than that of pad tests and standard urodynamic parameters. The correlation with pad-test data gives support to the validity of the method.

Adult↗