The Role of the Supine Empty Stress Test in the Evaluation of Women with Stress Urinary Incontinence: A Retrospective Cohort Study

• Published in: Journal of clinical medicine 2023-12, Vol.12 (24), p.7697
• Main Authors: Varlı, Bulut, Çetinkaya, Şerife Esra, Seval, Mehmet Murat, Dökmeci, Fulya
• Format: Article
• Language: English
• Subjects: Abdomen; Clinical medicine; Cohort analysis; Medical tests; Muscle strength; Normal distribution; Patients; Pelvic organ prolapse; Pelvis; Questionnaires; Surgery; Urinary incontinence; Urine; Vagina
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12247697

The International Continence Society recommends the supine empty stress test (SEST) as an accessory test in the evaluation of women with urinary incontinence, especially for the presence of intrinsic sphincter deficiency (ISD). The aim of this study was to investigate the relationship between the SEST and clinical findings in women diagnosed with stress urinary incontinence with single voiding cycle ambulatory urodynamics (AUM). AUM tracings of patients with lower urinary tract symptoms (LUTS = Lower urinary tract symptoms) ( = 513) were retrospectively reviewed, and 364 charts with urodynamic SUI were analyzed. Demographics, examination findings, scores of the Sandvik Incontinence Severity Index and validated questionnaires, and AUM findings were compared between SEST-positive and -negative groups. Additionally, the diagnostic accuracy of the SEST in the diagnosis of low abdominal leak point pressure (ALPP ≤ 60 cm H O) in women with pure urodynamic SUI was calculated. The SEST was positive in 41.8% ( = 152) of the cohort. Women with a positive SEST had higher scores on the Sandvik severity index (9.2 ± 3.6 vs. 7.5 ± 3.8, = 0.003) and lower ALPP (79.6 ± 29.3 vs. 98.4 ± 31.3, < 0.001). The negative predictive value of the SEST for ISD was found to be 92.4%. Thus, the SEST seems to be an objective clinical test reflecting urinary incontinence severity while excluding the presence of ISD.