The urine stream interruption test (UST)

For many years healthcare practitioners have been recommending that patients stop their urine to learn and training the PFMs.  Below is a collection of papers on the maneuver.  You may draw your own conclusion but I do not recommend this test as a measure of function or a training maneuver. 

1.       Sampselle CM, DeLancey JOD. The urine stream interruption test and pelvic muscle function Nurs Res 1992 41(2):73-77.

First article describe the test using a uroflow chair.  The showed repeatability and correlation between decreased PFM strength and slower speed of interrupting urine flow. 

Average time till stop:

·         Nulliparous = 1.96 seconds

·         Primiparas = 3.6 seconds

·         Multiparous = 4.4 seconds.  20 subjects.

2.       Sartore A. Pregazzi R, Bortoli P, et al. The urine stream interruption test (UST) and pelvic muscle function in the puerperium.  2002 In J Gynaecol Obstet 78(3):235-239.

492 post-partum females

Test described – completed on a uroflow chair. 5 seconds after start of void patient was given the signal to stop.  Time till full stop was calculated with normal = 3-4 seconds, abnormal = more than 5 seconds.  Need to have at least 150 ml in bladder for valid test.

Abnormal in 25% of patients with UI and 10% of continent patients. In other words 75% of patients with UI can pass this test.   It was shown to be reflective of change after PT Rx.

3.       Onyeka BA, Ogah J. Cystometric urine stream interruption test in women with urodynamic stress incontinence.  J Obstet Gynaecol 2006 26(7):667-668.

87% of women with SUI can pass USI test – poor indicator of function. 

4.       Amaro JL, Moreira ECH, Gameiro MDO, Padovani CR. Pelvic floor muscle evaluation in incontinence patients.  Int Urogynecol J 2005 16:352-354.

101 women, method is unclear and test is not described.  Blinding is also unclear. 

25.5% of patients with UI and 80% of continent patients can pass UST

5.       Sapsford RR, Hodges PW. The effect of abdominal and pelvic floor muscle activation on urine flow in women.  Int Urogynecol J 2012, Jan 26 Epub.

Abstract only. 8 healthy women of mixed parity.  Performed UST with PFM contraction and with abdominal muscle contraction.  All subjects could stop urine stream with either abdominal or PFM contraction – time to stop was not significantly different.  Conclusion – abdominal muscle contraction influences urethral closure.  This may be due to PFM contraction but does point out that several strategies can be used to pass the UST.