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Maximum Urethral Closure Pressure (MUCP)

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Also Known As

MUCP, Maximum Urethral Pressure Differential, Peak Urethral Closure Pressure, Maximal Urethral Closure Pressure, Maximum Urethral Sphincter Pressure

Definition

Maximum Urethral Closure Pressure (MUCP) is the maximum pressure difference between the urethral pressure and the intravesical pressure.1 It represents the peak pressure generated by the urethral sphincter muscles during a specific contraction.2 MUCP is a key urodynamic parameter measured during urethral pressure profilometry to assess urethral sphincter function and competence.3 This measurement quantifies the ability of the urethra to maintain continence by creating sufficient pressure to prevent urine leakage.4 MUCP is typically measured in centimeters of water (cmH₂O) and is an important diagnostic indicator in the evaluation of stress urinary incontinence and other lower urinary tract disorders.5

Clinical Context

Maximum Urethral Closure Pressure (MUCP) is primarily used in the clinical evaluation of urinary incontinence, particularly stress urinary incontinence (SUI) in women.1 During urodynamic testing, MUCP provides objective data about urethral sphincter function and competence, which is essential for proper diagnosis and treatment planning.2

Low MUCP values (typically <40 cmH₂O) have been significantly associated with stress urinary incontinence in multiple studies.3 Research has shown that MUCP values less than or equal to 20 cmH₂O have a sensitivity of 73.1% and a specificity of 93.0% for predicting SUI.2 This measurement helps clinicians differentiate between various types of incontinence and identify intrinsic sphincter deficiency.

MUCP is measured during urethral pressure profilometry, which is typically performed as part of a comprehensive urodynamic evaluation. The procedure involves the insertion of a specialized catheter into the urethra that measures pressure along its length.4 The patient is usually positioned at a 45° upright angle with a bladder volume of approximately 200 mL during the measurement.2

This parameter is particularly valuable in preoperative assessment for incontinence surgeries, as patients with very low MUCP may have poorer outcomes with certain surgical interventions.5 Recent studies have indicated that women with MUCP <40 cmH₂O, along with other anatomical factors, are more likely to have unfavorable outcomes following mid-urethral sling surgery.3

Scientific Citation

[1] Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk D, Sand PK, Schaer GK. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4-20; International Urogynecology J. 2010;21:5-26. DOI: 10.1002/nau.20798

[2] Pizzoferrato AC, Fauconnier A, Fritel X, Bader G, Dompeyre P. Urethral Closure Pressure at Stress: A Predictive Measure for the Diagnosis and Severity of Urinary Incontinence in Women. Int Neurourol J. 2017;21(2):121-127. DOI: 10.5213/inj.1732686.343

[3] Yao M, Shah K, Maganty A. Urodynamic Testing and Interpretation. StatPearls [Internet]. 2023. PMID: 33760472

[4] Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. DOI: 10.1002/nau.10052

[5] Lose G, Griffiths D, Hosker G, Kulseng-Hanssen S, Perucchini D, Schäfer W, Thind P, Versi E. Standardisation of urethral pressure measurement: report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn. 2002;21(3):258-60. DOI: 10.1002/nau.10039

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