5. Application of leak point pressure measurement in diagnosis of stress urinary incontinence in women at The University Medical Center of Ho Chi Minh City

Doan Vuong Kiet, Nguyen Van An, Pham Huy Vu, Le Truong Tuan Dat

Main Article Content

Abstract

The aim of this research is estimating the proportion of intrinsic sphincter deficiency (ISD) by result of leak point pressure (LPP) and related factors in female stress urinary incontinence (SUI). This is the case series report, females with SUI have done multichannel urodynamic study (UDS)  at the University Medicine Center of Ho Chi Minh city from 05/2019 to 07/2021. leak point pressure (LPP) measurement was used to diagnose ISD and cut-off point according to McGuire. There were 41 women with SUI who performed LPP measurement, 35 cases were positive, 1 patient was rejected due to poor bladder compliance and decreased bladder capacity (60mL).  41.2% women with SUI had ISD according to LPP ≤ 60cmH20. ISD was not correlated with the SUI severity according to Stamey's classification. ISD was negatively correlated with urethral hypermobility (p = 0.024) and positively correlated with supine empty bladder stress test (p = 0.028). In conclusion, 41.2% women with stress urinary incontinence (SUI) had intrinsic sphincter deficiency (ISD) according to leak point pressure (LPP)  ≤ 60cmH20. ISD should be suspected when women with SUI had urethral immobility and supine empty bladder stress test positive.

Article Details

References

1. Abrams P, Artibani W, Cardozo L, et al. Reviewing the ICS 2002 terminology report: the ongoing debate. Neurourol Urodyn. 2009; 28: 287.
2. McGuire EJ. Pathophysiology of stress urinary incontinence. Rev Urol. 2004; 6 (Suppl 5): S11–S17.
3. Daneshgari Firouz. Valsalva leak point pressure: Steps toward standardization. Current Urology Reports. 2001; 2 (5), pp. 388-391.
4. McGuire EJ, Cespedes RD, O’Connell HE: Leak point pressure. Urol Clin North Am. 1996; 23(2): 253–262.
5. Winters J.C., Dmochowski R. R., Goldman H. B., et al. Urodynamic studies in adults: AUA/SUFU guideline. J Urol. 2012; 188 (6 Suppl), pp. 2464-72.
6. Kadar N. The value of bladder filling in the clinical detection of urine loss and selection of patients for urodynamic testing. Br J Obstet Gynaecol. 1988; 95 (7), pp. 698-704.
7. McLennan M.T., Bent A.E. Supine empty stress test as a predictor of low valsalva leak point pressure. Neurourol Urodyn. 1998; 17 (2), pp. 121-7.
8. Nager C.W., Sirls L., Litman H.J., et al. Baseline urodynamic predictors of treatment failure 1 year after mid urethral sling surgery. J Urol. 2011; 186 (2), pp. 597-603.
9. Nitti VW, Combs AJ. Correlation of Valsalva leak point pressure with subjective degree of stress urinary incontinence in women. J Urol. 1996; 155:281–5. doi: 10.1016/S0022-5347(01)66619-9.
10. Albo M., Wruck L., Baker J., et al. The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence. J Urol. 2007; 177 (5), pp.1810-4.
11. Nager C. W., Kraus S. R., Kenton K., et al. Urodynamics, the supine empty bladder stress test, and incontinence severity. Neurourol Urodyn. 2010; 29 (7), pp. 1306-11.