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PAEDIATRIC UROLOGY

11.1.5 Urethral pressure profile (sphincterometry)

Resting or stress profile of the urethra is used to determine and quantify sphincter insufficiency; however, the method cannot verify subvesical obstruction. Urethral pressure profile measurement is indicated in the assessment of stress incontinence (e.g. post-traumatic, sinus urogenitalis, myelomeningocele). In children, only thin micro-tip catheters with urethral and vesical pressure transducer should be used. A continuous withdrawal is necessary to determine the functional length of the urethra (withdrawal speed of 2-10 cm/min; faster withdrawal produces higher pressure values). At rest, the urethral profile is determined by continuous withdrawal of the measuring sensor. In the urethral stress profile, the pressure in the urethra and the pressure transmission are determined during intermittent intra-abdominal pressure rises (e.g. coughing, Valsalva's manoeuvre). After voiding to completion, the bladder should be filled up to 50% of its maximum capacity with a maximum of 100 mL.