The Effect of Valsalva Leak Point Pressure on Outcomes of the Needleless ®System in Female Stress Urinary Incontinence.
OBJECTIVE
This study aimed to investigate the effects of preoperative Valsalva leak point pressure (VLPP) on the outcomes of the single-incision midurethral sling procedure (Needleless® System) in female stress urinary incon­tinence (SUI).


METHODS
We evaluated 112 patients who underwent midurethral sling placement for SUI using the Needleless® System. Patients were divided into two groups according to their preoperative VLPP values: VLPP >90 cmH2O (group 1) and VLPP 60-90 cmH2O (group 2). After the postoperative period, SUI status and satisfac­tion were compared between the two groups. Subjective cure was defined as the absence of any episodes of urinary incontinence associated with conditions that increase intra-abdominal pressure in daily life. Treatment satisfaction was analyzed according to patient responses as 'satisfied', 'neutral', and 'dissatisfied'. Postoperative other lower urinary tract symptoms except SUI were compared between the two groups too.


RESULTS
There were no significant differences in age, body weight, and urodynamic parameters (except VLPP) between the two groups. The mean VLPPs were 105.9 ± 12.3 cmH2O (range, 93.6-118.2 cmH2O) in group 1 and 75.4 ± 10.5 cmH2O (range, 65-85.9 cmH2O) in group 2. The overall subjective cure rates were 65.0% in group 1 and 62.5% in group 2 (P = .744). The overall satisfaction rates were 58.8% in group 1 and 68.8% in group 2 (P = .600). Complication rates did not differ between the two groups.


CONCLUSIONS
When stratified as > 90 cmH2O or ≤ 90 cmH2O, preoperative VLPP did not affect Needleless® Sys­tem outcomes in female SUI patients.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Seung Bum
SB
Han
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea. kjc@catholic.ac.kr.
Joon Chul
JC
Kim
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Dong Hwan
DH
Lee
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hyo Sin
HS
Kim
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jun Sung
JS
Koh
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Won Sok
WS
Hur
Department of Urology, The Catholic University of Korea, Bucheon St. Mary`s Hospital, 327 Sosa-Ro, Wonmi-gu, Bucheon-city, Gyeonggi-do, 420-717, Korea.
Kang Jun
KJ
Cho
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009339:Needles; D011184:Postoperative Period; D011312:Pressure; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures / Q000295:instrumentation*; D014636:Valsalva Maneuver