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[Predictive value of stress leak bladder pressure in urinary incontinence in children]
R Martín-Crespo Izquierdo1, G Barrientos Fernández, R Luque Mialdea
1Servicio de Cirugía Pediátrica, Unidad de Urodinámica, Hospital de Madrid Montepríncipe, Urbanización Montepríncipe, Avda. de Montepríncipe no 25, 28660 Boadilla del Monte, Madrid.
Insights
Stress leak point pressure effectively evaluates incontinence in children. This method helps identify intrinsic sphincter deficiency in pediatric patients, aiding clinical practice.
Area of Science:
- Urology
- Pediatric Urology
- Urodynamics
Context:
- Urinary incontinence is a common issue in children.
- Evaluating the underlying causes is crucial for effective management.
- Stress leak point pressure (SLPP) is a urodynamic parameter measuring bladder pressure at leakage during increased abdominal pressure.
Purpose:
- To investigate the utility of stress leak point pressure (SLPP) in assessing pediatric incontinence.
- To determine if SLPP can be applied to pediatric clinical practice.
- To differentiate causes of incontinence in neurologically normal children versus those with myelodysplasia.
Summary:
- A prospective study of 68 incontinent children (50 neurologically normal, 18 with myelodysplasia) was conducted.
- In neurologically normal children, 16% experienced leakage during stress, with SLPP > 100 cm H2O.
- In myelodysplasia patients, 100% showed leakage during stress, with SLPP < 100 cm H2O, indicating intrinsic sphincter deficiency.
Impact:
- Stress leak point pressure (SLPP) is a valuable diagnostic tool for pediatric incontinence.
- SLPP provides insights into proximal urethral and bladder neck function.
- This test aids in identifying intrinsic sphincter deficiency in the pediatric population.
Unlabelled:
The stress leak point pressure is the lowest bladder pressure at which leakage occurs during increases in intra-abdominal pressure. Our goal was the study of the stress leak point pressure in children to determine if it is a useful method of evaluation of incontinence and how it can be applied to pediatric clinical practice. We prospectively studied 68 consecutive incontinent children: Group 1 included 50 children neurologically normal. Group 2 included 18 children with myelodysplasia.
Results:
1) No correlation was found between stress leak point pressure and leak point pressure values. 2) The difference between the volumes at which the stress and rest leak were obtained was not statistically significant. 3) Study of stress leak point pressure: Group 1; Leakage during stress only occurs in 16%. Stress leak point pressure was greater than 100 cm of H2O in these children. Group 2; Leakage during stress occurs in all children (positive test in 100%). Stress leak point pressure was less than 100 cm of H2O, indicating intrinsic sphincter deficiency. These results suggest the stress leak point pressure is a diagnostic test that provide information about the function of proximal urethra and bladder neck in pediatric population, and an useful tool to despite of intrinsic sphincter deficiency.