The need for standardization of the Valsalva leak-point pressure
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The Valsalva leak-point pressure is a new test being advocated for evaluation of urethral sphincter function. However, there is currently no standardized technique for performing the test, and therefore it is difficult to draw conclusions regarding its ability to define the degree of function or dysfunction of the urethral sphincter mechanism. This article reviews the current literature regarding the parameters and techniques for performing the Valsalva leak-point pressure test. Based on what is known, recommendations for testing parameters and conditions under which the test should be performed are provided. This test may play a role in the evaluation of the urethral sphincter and give prognostic information regarding surgical outcomes, but first the technique for performing the test should be standardized and agreed upon. Until this is done no general conclusions can be drawn regarding the usefulness of this test in the evaluation of the incontinent woman.
KeywordsStandardization Technique Urodynamics
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- 3.Urinary Incontinence Guidelines Panel. Urinary incontinence in adults. Clinical practice guidelines, AHCPR publication 9-20038. Rockville, Maryland: Agency for Health Care Policy and Research, PHS, HHS, March 1992Google Scholar
- 4.McGuire EJ. Urodynamic findings in patients after failure of stress incontinence operations.Prog Clin Biol Res 1981:351–60.Google Scholar
- 5.Sand PK, Bowen LW, Panganiban R, Ostergard DR. The low pressure urethra as a factor in failed retropubic urethropexy.Obstet Gynecol 1987;68:399–402Google Scholar
- 6.Blaivis JG, Olsson CA: Stress incontinence: classification and surgical approach.J Urol 1988;39:727–731Google Scholar
- 10.Bump RC, Elser DM, Theofrastous JP, McClish DK and the Continence Program for Women Group. Valsalva leak point pressure in women with genuine stress incontinence: reproducibility, effect of catheter caliber, and correlations with other measures of urethral resistance.Am J Obstet Gynecol 1995;173:551–557PubMedGoogle Scholar
- 13.Theofrastous JP, Bump RC, Elser DM, Wyman JF, McClish DK and the Continence Program for Women Research Group. Correlation of urodynamic measures of urethral resistance with clinical measures of incontinence severity in women with pure genuine stress incontinence.Am J Obstet Gynecol 1995;173:407–414PubMedGoogle Scholar
- 15.Tanagho EA, Stoller ML. Urodynamics: cystometry and urethral closure pressure profile. In: Urogynecology and urodynamics: theory and practice, 3rd edn. Ostergard DR and Bent AE, eds. Baltimore: Williams and Wilkins, 1991;134–138Google Scholar
- 16.Theofrastous JP et al. Abstract presented at 16th annual American Urogynecologic Society meeting, Seattle WA, 1995Google Scholar
- 17.Lobel RW, Sand PK. Abstract presented at 16th annual American Urogynecologic Society meeting, Seattle WA, 1995Google Scholar
- 18.Germain MM et al. Abstract presented at 16th annual American Urogynecologic Society meeting, Seattle WA, 1995Google Scholar