Correlation of Valsalva Leak Point Pressure and Maximum Urethra Closure Pressure in Patients with Stress Urinary Incontinence

Kim, Hong Seok; Jeong, Young Beom; Park, Jong Kwan; Park, Young Kyung

Abstract

PURPOSE
The valsalva leak point pressure (VLPP), a quantitative measure of sphincteric function, is used widely to diagnose intrinsic sphincter deficiency (ISD). This study was to evaluate the correlation between VLPP and maximum urethra closure pressure (MUCP) in patients with stress urinary incontinence.
MATERIALS AND METHODS
We divided the patients into two categories: 60 patients affected by ISD as they had stress incontinence; 80 patients suffering from stress incontinence without ISD. The presence/absence of ISD was considered the dependent variable and was correlated against the following independent variables: age, vaginal deliveries, menopause, previous urogynecological surgery, VLPP, MUCP, and functional urethral length (FUL). This two groups were compared VLPP with MUCP to evlauate their correlation.
RESULTS
The statistical analysis showed close correlation between ISD and age (p=0.045), urogynecological surgery (p=0.013), VLPP (p=0.000), MUCP (p=0.000), FUL (p=0.000). There was statistically significant relationship between VLPP and MUCP (p=0.01), however a correlation coefficient of 0.303 demonstrated poor clinical relationship. When the cut-off value of MUCP were 20, 30, 40 cmH2O, there was no the diagnostic value of ISD.
CONCLUSION
The MUCP has statistically significant relationship with VLPP but, low correlation coefficient demonstrated poor clinical relationship. Therefore, it is not clinically useful to evaluate urethral sphincter function.