Valsalva Leak Point Pressure in Female Stress Urinary Incontinence: Reproducibility and Correlation with Maximum Urethral Closure Pressure

Lee, Kyu Sung; Oh, Sei Kwon; Lee, Sung Won

Abstract

PURPOSE: The valsalva leak point pressure(VLPP), a quantitative measure of sphincteric function, is used widely to diagnose intrinsic sphincteric deficiency. The purpose of this study was to assess the reproducibility of VLPP and to evaluate the correlation between VLPP and maximum urethral closure pressure(MUCP) in patients with stress urinary incontinence. MATERIALS AND METHODS: Thirty consecutive women with urodynamically confirmed genuine stress urinary incontinence underwent duplicate VLPP measurements. Inter-personal reproducibility of VLPP recording was obtained by two urologists in fifteen women. Intra-personal reproducibility of VLPP recording was obtained by one urologist in fifteen women. Each test was performed with two weeks interval, and was blinded to the previous results. Two hundred sixty two women with stress urinary incontinence were evaluated prospectively, comparing MUCP with VLPP to evaluate their correlation. RESULTS: Repeated measurements of VLPP were reproducible. Intra-personal agreement was excellent with a correlation coefficient of 0.95(p=0.0001) between the first and second examination. Inter-personal correlation coefficient was 0.85(p=0.0001). The difference between repeated measurement was not statistically significant. There was a statistically significant relationship between VLPP and MUCP(p=0.0001), however a correlation coefficient of 0.29 demonstrated poor clinical relationship. CONCLUSIONS: The VLPP is a simple and reproducible methods for evaluating urethral resistance in stress urinary incontinence. The MUCP has statistically significant relationship with VLPP, however it is not clinically useful to evaluate urethral sphincter function because women with normal or high MUCP had leakage at low VLPP and vice versa.