Tags

Type your tag names separated by a space and hit enter

Retrograde leak point pressure for evaluating postradical prostatectomy incontinence.
Urology. 1997 Feb; 49(2):231-6.U

Abstract

OBJECTIVES

To evaluate a technique of measuring the retrograde leak point pressure (RLPP) for assessing men with postradical prostatectomy stress urinary incontinence (SUI).

METHODS

We measured RLPP in adult men by retrograde infusion of the distal urethra while simultaneously recording intraurethral pressure. The reproducibility of this test, and its dependence on urethral infusion rate, bladder volume, and anterior urethral catheter position, were evaluated. RLPP and abdominal leak point pressure (ALPP) measurements were performed in postradical prostatectomy patients. RLPP was compared with ALPP and with severity of incontinence determined by pad usage.

RESULTS

Repeated RLPP measurements were not significantly different and did not change with bladder volume up to half capacity or with the location of the catheter in the anterior urethra. The differences between RLPP measurements with infusion rates of 2, 4, and 8 mL/min were also not significant. Twenty-seven men were evaluated 6 to 108 months after surgery. Of these, 22 (81%) demonstrated SUI. Mean RLPP in men without SUI (79.2 +/- 14 cm H2O) was significantly higher than in men with SUI (51.9 +/- 13 cm H2O, P < 0.01). In men with SUI, ALPP and RLPP were significantly correlated, and ALPP (49.8 +/- 24 cm H2O) was not significantly different from RLPP (51.9 +/- 13 cm H2O) Pad use and RLPP were also significantly related.

CONCLUSIONS

RLPP measurements are reproducible and simple to perform. The pressure at which leakage occurs is easily identifiable as the plateau pressure. RLPP correlates significantly with the lowest of multiple ALPP measurements in men with SUI. This technique represents a reliable urodynamic alternative for evaluating men with postradical prostatectomy SUI.

Authors+Show Affiliations

Division of Urology, West Roxbury V.A. Medical Center, Massachusetts, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

9037285

Citation

Comiter, C V., et al. "Retrograde Leak Point Pressure for Evaluating Postradical Prostatectomy Incontinence." Urology, vol. 49, no. 2, 1997, pp. 231-6.
Comiter CV, Sullivan MP, Yalla SV. Retrograde leak point pressure for evaluating postradical prostatectomy incontinence. Urology. 1997;49(2):231-6.
Comiter, C. V., Sullivan, M. P., & Yalla, S. V. (1997). Retrograde leak point pressure for evaluating postradical prostatectomy incontinence. Urology, 49(2), 231-6.
Comiter CV, Sullivan MP, Yalla SV. Retrograde Leak Point Pressure for Evaluating Postradical Prostatectomy Incontinence. Urology. 1997;49(2):231-6. PubMed PMID: 9037285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrograde leak point pressure for evaluating postradical prostatectomy incontinence. AU - Comiter,C V, AU - Sullivan,M P, AU - Yalla,S V, PY - 1997/2/1/pubmed PY - 1997/2/1/medline PY - 1997/2/1/entrez SP - 231 EP - 6 JF - Urology JO - Urology VL - 49 IS - 2 N2 - OBJECTIVES: To evaluate a technique of measuring the retrograde leak point pressure (RLPP) for assessing men with postradical prostatectomy stress urinary incontinence (SUI). METHODS: We measured RLPP in adult men by retrograde infusion of the distal urethra while simultaneously recording intraurethral pressure. The reproducibility of this test, and its dependence on urethral infusion rate, bladder volume, and anterior urethral catheter position, were evaluated. RLPP and abdominal leak point pressure (ALPP) measurements were performed in postradical prostatectomy patients. RLPP was compared with ALPP and with severity of incontinence determined by pad usage. RESULTS: Repeated RLPP measurements were not significantly different and did not change with bladder volume up to half capacity or with the location of the catheter in the anterior urethra. The differences between RLPP measurements with infusion rates of 2, 4, and 8 mL/min were also not significant. Twenty-seven men were evaluated 6 to 108 months after surgery. Of these, 22 (81%) demonstrated SUI. Mean RLPP in men without SUI (79.2 +/- 14 cm H2O) was significantly higher than in men with SUI (51.9 +/- 13 cm H2O, P < 0.01). In men with SUI, ALPP and RLPP were significantly correlated, and ALPP (49.8 +/- 24 cm H2O) was not significantly different from RLPP (51.9 +/- 13 cm H2O) Pad use and RLPP were also significantly related. CONCLUSIONS: RLPP measurements are reproducible and simple to perform. The pressure at which leakage occurs is easily identifiable as the plateau pressure. RLPP correlates significantly with the lowest of multiple ALPP measurements in men with SUI. This technique represents a reliable urodynamic alternative for evaluating men with postradical prostatectomy SUI. SN - 0090-4295 UR - https://www.unboundmedicine.com/medline/citation/9037285/Retrograde_leak_point_pressure_for_evaluating_postradical_prostatectomy_incontinence_ DB - PRIME DP - Unbound Medicine ER -