Document Detail


Correlation among maximal urethral closure pressure, retrograde leak point pressure, and abdominal leak point pressure in men with postprostatectomy stress incontinence.
MedLine Citation:
PMID:  12837426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the correlation among abdominal leak point pressure (ALPP), maximal urethral closure pressure (MUCP), and retrograde leak point pressure (RLPP) in the evaluation of men with stress urinary incontinence (SUI) after radical prostatectomy. METHODS: Patients were evaluated with a self-administered questionnaire regarding pad use and with multichannel videourodynamics. The ALPP, MUCP, and RLPP were compared with each other and with the severity of SUI. RESULTS: The mean ALPP was 49.4 +/- 24.4 cm H(2)O. The mean MUCP was 52.0 +/- 21.1 cm H(2)O. The mean RLPP was 48.0 +/- 13.5 cm H(2)O. No statistically significant difference in the mean values of the three parameters was found. Regression analysis revealed a statistically significant correlation among the three parameters: RLPP versus MUCP, r = 0.59, P <0.005; MUCP versus ALPP, r = 0.75, P <0.0001; and RLPP versus ALPP, r = 0.79, P <0.0001. ALPP, MUCP, and RLPP were each significantly related to pad use. CONCLUSIONS: Intrinsic sphincter deficiency is the primary cause of SUI after radical prostatectomy. Therefore, evaluation of intrinsic sphincter function is important in the treatment of postprostatectomy SUI. In incontinent men after radical prostatectomy, with a dysfunctional bladder neck and proximal sphincter unit, the intrinsic function of this distal sphincter may be assessed equally well by evaluating the resistance to antegrade leakage, retrograde leakage, or profilometric measurement of the urethral closure pressure. RLPP and MUCP offer reliable alternatives to ALPP for the evaluation of postprostatectomy SUI.
Authors:
Craig V Comiter; Maryrose P Sullivan; Subbarao V Yalla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  62     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-02     Completed Date:  2003-10-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  75-8     Citation Subset:  IM    
Affiliation:
Section of Urology, Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery
Aged
Humans
Male
Muscle, Smooth / physiopathology
Predictive Value of Tests
Pressure
Prostatectomy / adverse effects*,  methods
Prostatic Neoplasms / surgery
Urethra / physiopathology*
Urinary Incontinence, Stress / etiology,  physiopathology*
Urodynamics*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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