The modified mean urethral pressure gradient as it relates to urodynamics: a prognostic indicator of upper urinary tract distress.

Abstract

An urodynamic variable, the Modified Mean Urethral Pressure ·Gradient (MUPG), • 9 was evaluated to identify the risk of adult males with ·spinal cord injury (SCI) or multiple sclerosis (MS) for developing upper urinary tract :distress. The mMUPG was ca~culated ( from urodynamic inforrilation; urethral pressures were measured at the prostatic urethra . . Upper tract distress induded symptotrul:tic or c~lture p·~sitive urinary tract infections, renal insufficiency, vesicoureteral reflux, hydronephrosis, and stones. { Five hundred and seventy-nine urodynamic studies from227 SCI and MS adult males were reviewed. The mMUPG, MaxPdet (maximal detrusor pressure), and Max Pura (maximal urethral pressure) values were analyzed for correlation with upper tract . \ dtstress. Subjects with a higher incidence of renal insufficiency had lower mMUPG values (p=0.0416); subjects with a higher incidence of stones had lower Max Pdet values (p=0.0233). The mMUPG and Max Pdet values indicated an inverse relationship to renal insufficiency and stones, respectively. The mMUPG , Max Pdet, and Max Pura did not aid in the detection of upper tract distress.