title: Preoperative MUCP and VLPP did not predict long-term (4-year) outcome after transobturator mid-urethral sling.
abstract: OBJECTIVE
  Maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) have been considered objective parameters for studying the urethral integrity and predicting outcome after surgery for stress urinary incontinence (SUI). We test the hypothesis that preoperative MUCP and/or VLPP may predict long-term outcome after out-in transobturator tape (TOT) surgery for female SUI.
  
  
  METHODS
  65 patients affected by stress or mixed urinary incontinence were enrolled in a prospective observational descriptive study conducted from May 2002 to November 2005 at a single tertiary urban teaching university urogynecological department. Preoperative MUCP and VLPP, stratified as < or = or >40 cm H(2)O and < or = or >60 cm H(2)O, respectively, were separately or in combination correlated with primary (continence status: dry or wet) and secondary outcome variables (quality of life questionnaires) after surgery.
  
  
  RESULTS
  Out of 65 patients, 6 (9.2%) did not attend the follow-up. The median follow-up was 46 months (mean 52 +/- 18; range 36-82). The overall objective cure rates (dry) were 74.4% for patients with VLPP >60 cm H(2)O and 65% for VLPP < or =60 cm H(2)O (p < 0.654). The overall objective cure rates (dry) were 75% for patients with MUCP >40 cm H(2)O and 68.6% for MUCP < or =40 cm H(2)O (p < 0.808). The overall objective cure rates (dry) were 82.4% for patients with MUCP >40 cm H(2)O and VLPP >60 cm H(2)O and 69.2% for MUCP < or =40 cm H(2)O and VLPP < or =60 cm H(2)O (p < 0.956).
  
  
  CONCLUSIONS
  These data seem to cast doubts on the predictive value of MUCP and VLPP in patients who underwent TOT.
authors.affiliation: Section of Urology and Andrology, Department of Medical-Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
authors.forename: Antonella
authors.initials: A
authors.lastname: Giannantoni
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Michele
authors.initials: M
authors.lastname: del Zingaro
authors.forename: Massimo
authors.initials: M
authors.lastname: Porena
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011312:Pressure; D011446:Prospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000601:surgery*; D014563:Urodynamics