Urodynamic leak point pressures weakly correlate with subjective urinary incontinence severity.
OBJECTIVE
To evaluate preoperative abdominal leak point pressures (ALPP) with pre- and postoperative Incontinence Severity Index (ISI) scores.


METHODS
A review of women who underwent a midurethral sling procedure between August 2004 and April 2006 was conducted. Eligible women completed preoperative urodynamic testing with ALPP determination and subjective incontinence severity assessment using the ISI before and 6 weeks after surgery. The ISI and ALPP relationship was analyzed using a Spearman rank correlation (Rho).


RESULTS
Ninety-nine women met the inclusion criteria. Mean ALPP was 77.7 (25-172 cm H2O). Mean improvement in ISI following surgery was 4 (-8 to 12). ALPP correlated with preoperative ISI (Spearman Rho -0.28, P=0.01), preoperative leakage frequency (ISI question 1) (Spearman Rho -0.32, P=0.001), and the ISI change 6 weeks postoperatively (ISI-delta) (Spearman Rho -0.23, P=0.002).


CONCLUSIONS
ALPP is associated with subjective incontinence severity. Women with the lowest ALPP improved most following a midurethral sling procedure.
Grimes
Cara L
CL
Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Hanissian
Paul D
PD
Strohbehn
Kris
K
Goldman
Marlene B
MB
Whiteside
James L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*; D014563:Urodynamics