Stress leak point pressure: a simple and reproducible method utilizing a fiberoptic microtransducer.
OBJECTIVE
This work demonstrates a simple technique utilizing a fiberoptic microtransducer that provides statistically reproducible stress leak point pressure (SLPP) results without the use of fluorourodynamics.


METHODS
Nineteen stress incontinent patients with varied clinical histories underwent two SLPP measurements on 2 separate days, totaling four data points. A 14 F catheter sheath was inserted to empty the bladder. Through this sheath, a 5 F fiberoptic microtransducer was inserted into the bladder and zeroed. Then, 250 cc of indigo-carmine solution was instilled, during which a filling cystometrogram was performed. The sheath was removed, leaving only the 5 F transducer in the bladder. A 2 by 2 inch gauze was placed at the meatus. As each participant performed a slow Valsalva maneuver, an event marker was used to note the pressure at which indigo solution was first seen to stain the gauze.


RESULTS
SLPPs ranged from 15 to 140 cm water (H2O). A two-tailed paired t test demonstrated no statistical difference (P < 0.6) between the two SLPPs performed on day 1, with a mean difference of 1.05 +/- 2.61 (95% confidence interval [CI]). Comparison of the two SLPPs performed on day 2 also revealed no statistical difference (P < 0.8), with a mean difference of -0.17 +/- 5.65 (95% CI). Lastly, comparison of the mean SLPPs from day 1 with the mean SLPPs from day 2 revealed no statistically significant difference (P < 0.8), with the mean difference of -0.59 +/- 1.62 (95% CI).


CONCLUSIONS
This study demonstrates a simple technique that produces reproducible SLPP measurements in a wide variety of clinical settings and avoids ionizing radiation.
Song
J T
JT
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0330, USA.
Rozanski
T A
TA
Belville
W D
WD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011468:Prostatectomy / Q000009:adverse effects; D015203:Reproducibility of Results; D014159:Transducers; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*