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Low valsalva leak-point pressure and success of retropubic urethropexy.

Abstract

The aim of this study was to determine whether an isolated low Valsalva leak-point pressure (VLPP) is predictive of intrinsic sphincter deficiency (ISD) and can be an independent risk factor for retropubic urethropexy failure in patients with a normal maximal urethral closure pressure (MUCP). Twenty-four women with urodynamically proven genuine stress incontinence with low VLPP (<60 cmH2O) and normal MUCP (>20 cmH2O) were evaluated subjectively and objectively by complex urodynamic testing before and after undergoing a modified Burch urethropexy. Success rates were then compared to historical success rates for subjects with ISD treated with retropubic urethropexy using an exact one-sample test for binomial proportions. Patients were followed postoperatively for a mean of 11.1 months, with a range of 5-16 months. Twenty-two of the 24 (91.7%) were continent on postoperative cystometry. This differs significantly from the published success rates of 50% (P < 0.001), if a low VLPP alone were predictive of ISD. Retropubic urethropexy was successful in the majority of our patients with genuine stress incontinence with a low VLPP and normal MUCP.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033, USA. Jeffhmd@aol.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11294532

Citation

Hsieh, G C., et al. "Low Valsalva Leak-point Pressure and Success of Retropubic Urethropexy." International Urogynecology Journal and Pelvic Floor Dysfunction, vol. 12, no. 1, 2001, pp. 46-50.
Hsieh GC, Klutke JJ, Kobak WH. Low valsalva leak-point pressure and success of retropubic urethropexy. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(1):46-50.
Hsieh, G. C., Klutke, J. J., & Kobak, W. H. (2001). Low valsalva leak-point pressure and success of retropubic urethropexy. International Urogynecology Journal and Pelvic Floor Dysfunction, 12(1), 46-50.
Hsieh GC, Klutke JJ, Kobak WH. Low Valsalva Leak-point Pressure and Success of Retropubic Urethropexy. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(1):46-50. PubMed PMID: 11294532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low valsalva leak-point pressure and success of retropubic urethropexy. AU - Hsieh,G C, AU - Klutke,J J, AU - Kobak,W H, PY - 2001/4/11/pubmed PY - 2001/6/22/medline PY - 2001/4/11/entrez SP - 46 EP - 50 JF - International urogynecology journal and pelvic floor dysfunction JO - Int Urogynecol J Pelvic Floor Dysfunct VL - 12 IS - 1 N2 - The aim of this study was to determine whether an isolated low Valsalva leak-point pressure (VLPP) is predictive of intrinsic sphincter deficiency (ISD) and can be an independent risk factor for retropubic urethropexy failure in patients with a normal maximal urethral closure pressure (MUCP). Twenty-four women with urodynamically proven genuine stress incontinence with low VLPP (<60 cmH2O) and normal MUCP (>20 cmH2O) were evaluated subjectively and objectively by complex urodynamic testing before and after undergoing a modified Burch urethropexy. Success rates were then compared to historical success rates for subjects with ISD treated with retropubic urethropexy using an exact one-sample test for binomial proportions. Patients were followed postoperatively for a mean of 11.1 months, with a range of 5-16 months. Twenty-two of the 24 (91.7%) were continent on postoperative cystometry. This differs significantly from the published success rates of 50% (P < 0.001), if a low VLPP alone were predictive of ISD. Retropubic urethropexy was successful in the majority of our patients with genuine stress incontinence with a low VLPP and normal MUCP. UR - https://www.unboundmedicine.com/medline/citation/11294532/Low_valsalva_leak_point_pressure_and_success_of_retropubic_urethropexy_ L2 - https://medlineplus.gov/pelvicfloordisorders.html DB - PRIME DP - Unbound Medicine ER -