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Published on: April 27, 2014
Urodynamic leak point pressures weakly correlate with subjective urinary incontinence severity
Cara L Grimes1, Paul D Hanissian, Kris Strohbehn
1Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Objective:
To evaluate preoperative abdominal leak point pressures (ALPP) with pre- and postoperative Incontinence Severity Index (ISI) scores.
Methods:
A review of women who underwent a midurethral sling procedure between August 2004 and April 2006 was conducted. Eligible women completed preoperative urodynamic testing with ALPP determination and subjective incontinence severity assessment using the ISI before and 6 weeks after surgery. The ISI and ALPP relationship was analyzed using a Spearman rank correlation (Rho).
Results:
Ninety-nine women met the inclusion criteria. Mean ALPP was 77.7 (25-172 cm H2O). Mean improvement in ISI following surgery was 4 (-8 to 12). ALPP correlated with preoperative ISI (Spearman Rho -0.28, P=0.01), preoperative leakage frequency (ISI question 1) (Spearman Rho -0.32, P=0.001), and the ISI change 6 weeks postoperatively (ISI-delta) (Spearman Rho -0.23, P=0.002).
Conclusion:
ALPP is associated with subjective incontinence severity. Women with the lowest ALPP improved most following a midurethral sling procedure.
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