Document Detail


Retrograde leak point pressure for evaluating postradical prostatectomy incontinence.
MedLine Citation:
PMID:  9037285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
C V Comiter; M P Sullivan; S V Yalla
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Urology     Volume:  49     ISSN:  0090-4295     ISO Abbreviation:  Urology     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-14     Completed Date:  1997-03-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  231-6     Citation Subset:  IM    
Affiliation:
Division of Urology, West Roxbury V.A. Medical Center, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Humans
Male
Middle Aged
Pressure
Prostatectomy / adverse effects*
Reproducibility of Results
Urinary Catheterization
Urinary Incontinence, Stress / diagnosis*,  etiology

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


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