Urodynamic assessment of a woman with severe stress urinary incontinence shows a maximum urethral closure pressure of 15 cm H2O. This finding establishes the diagnosis of:

• A Urethral hypermobility
• B Intrinsic sphincter deficiency ✓
• C Detrusor overactivity
• D Overflow incontinence

Explanation

Intrinsic sphincter deficiency is defined by a maximum urethral closure pressure below 20 cm H2O, often with a Valsalva leak point pressure below 60 cm H2O, reflecting a weak internal sphincteric mechanism rather than simple hypermobility. It predicts poor results from a mid-urethral sling alone and favours pubovaginal sling or bulking agents. Urethral hypermobility is an anatomical finding, not a closure pressure value.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.