Test useful for suspected suburethral diverticulum. (Use Early in Evaluation Process).

ST. LOUIS -- Positive-pressure urethrography is a very useful test early in the clinical evaluation of patients with a suspected suburethral diverticulum, Dr. C. Rodney Meeks said at the 12th International Pelvic Reconstructive and Vaginal Surgery Conference.

Indeed, it's a good next step after taking a history, performing a physical exam, and obtaining a urinalysis and culture, added Dr. Meeks, professor of ob.gyn. at the University of Mississippi, Jackson, and president of the Society of Gynecologic Surgeons.

Positive-pressure urethrography is helpful in two distinct ways. First, to confirm the diagnosis, a biphasic notch in the urethral pressure profile is indicative of a suburethral diverticulum. Second, the test lets the surgeon know in advance whether incontinence is likely to be a problem following diverticulectomy.

Information regarding incontinence risk is gained by comparing the location of the dip in urethral pressure with the site of the maximum urethral closing pressure. If the lesion is located distal to the point of maximum urethral closing ...