Leak point pressure measurement and stress urinary incontinence

This article reviews literature on leak point pressure (LPP) measurement as a diagnostic test for stress urinary incontinence in women. LPP is not consistently defined and techniques are not standardized, introducing variation in test results. Reproducibility of LPP is poor, both because of biological variation and variation within the test procedure itself (related in part to lack of standardization). Although not well studied, LPP values do correspond to the severity of incontinence symptoms, as a quantitative indication of the level of urethral dysfunction. However, there is no prospective evidence to support the commonly used cutoff of 60 cm H2O as an indication of intrinsic sphincter deficiency. LPP is potentially useful as a clinical and research tool for evaluating stress urinary incontinence in women. However, its use in clinical management is not well supported by evidence and further research is critically important to define its role.